Individual provider Active NPI

Michelle S. Nuxoll, LCSW

  • Social Worker
  • Woodside, NY
National Provider Identifier
1962719989
Registry record updated Dec 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
084229-1 Issued in NY
Practice address
6120 Woodside Ave
Woodside, NY 11377-3577
Phone
(718) 672-1705
NPI assigned
Sep 13, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2018

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 084229-1 NY Primary

Addresses

Primary practice location

6120 Woodside Ave
Woodside, NY 11377-3577

Mailing address

6120 Woodside Ave
Woodside, NY 11377-3577
Phone (718) 672-1705

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
I20190110001505 NY Practitioner - Clinical Psychologist 5496091597 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
084229-1NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Young Adult Institute, Inc. CurrentSince Nov 5, 2018 Accepting new patients

Locations

21111 Northern Blvd
Bayside, NY 11361
Phone (212) 563-7474

3060 E Tremont Ave
Bronx, NY 10461
Phone (718) 239-1790

220 E 42nd St
Fl 8
New York, NY 10017
Phone (212) 273-2761

460 W 34th St
Fl 11
New York, NY 10001
Phone (212) 273-6515

Organizations & group practices 1

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": "1284336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545177600000",
    "number": "1962719989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6120 WOODSIDE AVE",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113773577",
            "telephone_number": "718-672-1705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6120 WOODSIDE AVE",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113773577",
            "telephone_number": "718-672-1705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUXOLL",
        "first_name": "MICHELLE",
        "middle_name": "S.",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-13",
        "last_updated": "2018-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "084229-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodside, NY

Sources for this page

Verify at the official NPI Registry.