Individual provider Active NPI

Mildred Adrianna Simplicio, LMSW, CASAC

  • Social Worker
  • Long Island City, NY
National Provider Identifier
1902324106
Registry record updated Aug 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
101645 Issued in NY
Practice address
29-76 Northern Boulevard
Long Island City, NY 11101
Phone
(212) 691-7554
NPI assigned
Sep 7, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 101645 NY Primary

Addresses

Primary practice location

29-76 Northern Boulevard
Long Island City, NY 11101

Mailing address

651 Academy St
New York, NY 10034-5003
Phone (914) 262-0163

Other practice location 1

651 Academy Street
2nd floor
New York, NY 10034
Phone (212) 942-0043 ext. 127

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240305001836 NY Practitioner - Clinical Social Worker 4486099017 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
101645NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA CurrentSince Feb 2, 2024 Accepting new patients
The Fortune Society CurrentSince Sep 5, 2021 Accepting new patients
Healing Hearts Wellness and Care, LLC CurrentSince Aug 16, 2024 Accepting new patients
Inwood Community Services, Inc. Past Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

2976 Northern Blvd
Long Island City, NY 11101
Phone (212) 691-7554

165 Broadway
Fl 23
New York, NY 10006
Phone (202) 972-4964

15900 Riverside Dr W
New York, NY 10032

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1504742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1902324106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "651 ACADEMY ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100345003",
            "telephone_number": "914-262-0163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29-76 NORTHERN BOULEVARD",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "11101",
            "telephone_number": "212-691-7554"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "651 Academy Street",
            "address_2": "2nd floor",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10034",
            "country_code": "US",
            "telephone_number": "212-942-0043 x127",
            "fax_number": "212-942-3684",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMPLICIO",
        "first_name": "MILDRED",
        "middle_name": "ADRIANNA",
        "credential": "LMSW, CASAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-07",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "101645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Island City, NY

Sources for this page

Verify at the official NPI Registry.