| Evan Michaels Lcsw Pc | |
|
2116 Merrick Ave Ste 2001 Merrick NY 11566-3409 | |
| (917) 576-0720 | |
| Not Available |
| Full Name | Evan Michaels Lcsw Pc |
|---|---|
| Speciality | Social Worker |
| Location | 2116 Merrick Ave Ste 2001, Merrick, New York |
| Authorized Official Name and Position | Evan M Michaels (OWNER) |
| Authorized Official Contact | 9175760720 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evan Michaels Lcsw Pc 2116 Merrick Ave Ste 2001 Merrick NY 11566-3409 Ph: (917) 576-0720 | Evan Michaels Lcsw Pc 2116 Merrick Ave Ste 2001 Merrick NY 11566-3409 Ph: (917) 576-0720 |
| NPI Number | 1316695018 |
|---|---|
| Provider Enumeration Date | 03/13/2022 |
| Last Update Date | 03/13/2022 |
| Certification Date | 03/13/2022 |
| Medicare PECOS PAC ID | 3173910767 |
|---|---|
| Medicare Enrollment ID | O20220429000473 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316695018 | NPI | - | NPPES |
| 02454837 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Evan M Michaels |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417022658 PECOS PAC ID: 8729098900 Enrollment ID: I20060502000904 |
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