Active NPI
Michelle Kyliavas, LMSW
- Social Worker
- Prescott Valley, AZ
National Provider Identifier
1962246728
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 19461
- Practice address
- 3173 N Windsong Dr
Prescott Valley, AZ 86314-2240 - Phone
- (928) 493-8222
- NPI assigned
- Jun 25, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 19461 | AZ | Primary |
Addresses
Primary practice location
3173 N Windsong Dr
Prescott Valley, AZ 86314-2240
Mailing address
11286 E Western Sunset Dr
Dewey, AZ 86327-5634
Phone (480) 772-8083
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19461 | AZ | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1719273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719273600000",
"number": "1962246728",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11286 E WESTERN SUNSET DR",
"city": "DEWEY",
"state": "AZ",
"postal_code": "863275634",
"telephone_number": "480-772-8083"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3173 N WINDSONG DR",
"city": "PRESCOTT VALLEY",
"state": "AZ",
"postal_code": "863142240",
"telephone_number": "928-493-8222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KYLIAVAS",
"first_name": "MICHELLE",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-06-25",
"last_updated": "2024-06-25",
"certification_date": "2024-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "AZ",
"license": "19461",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Prescott Valley, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.