Mika Fukuyoshi, LCSW, CASAC 2

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

094064 Issued in NY

Practice address

511 6TH Ave # 7259
New York, NY 10011-8436

Phone

(346) 410-0375

NPI assigned

Feb 22, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Odyssey House, Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Bronx, NY
  • NPI 1013976976
  NPD (past)
• Odyssey House, Inc.

  • Community/Behavioral Health Agency
  • Bronx, NY
  • NPI 1811351307
  NPD (past)

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

{
    "created_epoch": "1550793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1962969287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 6TH AVE # 7259",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100118436",
            "telephone_number": "346-410-0375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 6TH AVE # 7259",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100118436",
            "telephone_number": "346-410-0375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUKUYOSHI",
        "first_name": "MIKA",
        "credential": "LCSW, CASAC 2",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-22",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "0193827",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "094064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zvi Fuks, MD
• Kristopher Michal Fuksman
• Airi Fukuda
• Takumi Fukunaga, DPT, SCS, ATC, CSCS
• Kisho Michael Fukuoka-Armitage, MD
• Fumitoshi Fukuzawa, M.D.
• Heidi Fuld, CCC-SLP
• Judith Fulda
• Christina Danielle Fulga
• Melissa Fulgieri, L.M.S.W

• Clinical Social Worker in New York, NY
• Providers in New York, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 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.

Verify at the official NPI Registry.