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KERI MICA LCSW PC NPI 1053502518


NPI Information

NPI: 1053502518
Provider Name: KERI MICA LCSW PC
Classification: Social Worker - 1041C0700X
Entity Type: Organization

Specialization: Clinical

Address:
176 N VILLAGE AVE
SUITE 2E
ROCKVILLE CENTRE, NY
ZIP 11570
Phone: (516) 410-7138
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KERI MICA LCSW PC is a clinical social worker in Rockville Centre, NY. The provider is a social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. KERI MICA LCSW PC NPI is 1053502518. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

176 N VILLAGE AVE
SUITE 2E
ROCKVILLE CENTRE, NY
ZIP 11570-800
Phone: (516) 410-7138
Fax: (516) 679-0736

The provider's authorized official is Keri Lynn Mica-suttmiller .
The authorized official title is President and has the following contact phone number (516) 410-7138.

The enumeration date for this NPI number is 8/8/2007 and was last updated on 8/8/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11041C0700XSocial WorkerClinicalYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1Q62025MEDICARE UPINNEW YORK
2N38T61MEDICARE OSCAR/CERTIFICATIONNEW YORK
302735202MEDICAIDNEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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