Michaeleen McMahon Anderson, LCSW
Social Worker, Clinical in Holbrook, NY. Individual provider (NPI-1).
NPI number1720157571
StatusActive
Last updated in NPPESMay 25, 2021
Details
- NPI
- 1720157571
- Entity type
- Individual (NPI-1)
- Name
- Michaeleen McMahon Anderson
- Credential
- LCSW
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Nov 7, 2006
- Certification date
- May 25, 2021
- Last updated
- May 25, 2021
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | R045247-1 | NY | Yes |
| 101YM0800X | Counselor, Mental Health | R045247-1 | NY |
Practice location
991 Main StSuite 102
Holbrook, NY 11741-1608
Phone 631-981-4419 · Fax 631-981-4419
Mailing address
991 Main StSuite 102
Holbrook, NY 11741-1608
Phone 631-981-4419 · Fax 631-981-4419
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