Individual provider Active NPI

Michelle S. Lyons-Fadel, MSS, LCSW

  • Clinical Social Worker
  • Philadelphia, PA
National Provider Identifier
1982855151
Registry record updated Mar 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW008269L Issued in PA
Practice address
7600 Stenton Ave.
Ste 1F
Philadelphia, PA 19118-3245
Phone
(215) 247-5400
Fax
(215) 247-5175
NPI assigned
Oct 7, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CW008269L PA Primary

Addresses

Primary practice location

7600 Stenton Ave.
Ste 1F
Philadelphia, PA 19118-3245

Mailing address

7600 Stenton Ave.
Suite 1F
Philadelphia, PA 19118-3245
Phone (215) 641-5835

Other identifiers 1

IdentifierTypeStateIssuer
600535191OtherPAMAGELLAN

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

LicenseStateTypeSpecialty
CW008269LPAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Evergreen Counseling and Psychological Associates LLC Clinical PastSince Mar 20, 2017 Accepting new patients
Evergreen Counseling Associates Clinical Past Accepting new patients

Organizations & group practices 2

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": "1223337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300924800000",
    "number": "1982855151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 STENTON AVE.",
            "address_2": "SUITE 1F",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191183245",
            "telephone_number": "215-641-5835",
            "fax_number": "215-247-5175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 STENTON AVE.",
            "address_2": "STE 1F",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191183245",
            "telephone_number": "215-247-5400",
            "fax_number": "215-247-5175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYONS-FADEL",
        "first_name": "MICHELLE",
        "middle_name": "S.",
        "credential": "MSS, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-07",
        "last_updated": "2011-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW008269L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "600535191",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2011; 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.