Provider Demographics
NPI:1972841260
Name:NETZLER, MICHELE (MSW)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:NETZLER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7706 13TH AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228-2414
Mailing Address - Country:US
Mailing Address - Phone:718-748-1234
Mailing Address - Fax:718-748-0353
Practice Address - Street 1:9201 4TH AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-7065
Practice Address - Country:US
Practice Address - Phone:718-748-1234
Practice Address - Fax:718-748-0353
Is Sole Proprietor?:No
Enumeration Date:2013-01-22
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY082046-11041C0700X
NY088118104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical