Individual provider · Type 1 NPI
Michael Jason Wickham, LCSW
Clinical Social Worker · Port Jervis, NY
Practice location
146 Pike Street
Port Jervis, NY 12771-1939
Fax (845) 378-3283
Mailing address
118 Glenmere Ave
Florida, NY 10921-1210
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Clinical Social Worker | 1041C0700X | 257898 (KY) |
| Clinical Social Worker Primary | 1041C0700X | 095201-01 (NY) |
| Clinical Social Worker | 1041C0700X | 44SC05923700 (NJ) |
Clinical Social Worker: 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 interpers…
5 other providers at this address
- County of OrangeMental Health Clinic/Center (Including Community Mental Health Center) Port Jervis, NY NPI 1740227214
- Christine Smallin, LCSWClinical Social Worker Port Jervis, NY NPI 1144474461
- Lillian RothenhausMental Health Counselor Port Jervis, NY NPI 1346574571
- Martha McPhail Thomson, NPPsychiatric/Mental Health Nurse Practitioner Port Jervis, NY NPI 1417149659
- Phillip Whayne Bennett, LCSWClinical Social Worker Port Jervis, NY NPI 1629223730
Other clinical social worker providers in Port Jervis
- Lawrence Edward Smith, LCSWClinical Social Worker Port Jervis, NY NPI 1033161963
- Timothy Richard Gregory, LCSWClinical Social Worker Port Jervis, NY NPI 1083623177
- Rita Marie Lawler, LCSWClinical Social Worker Port Jervis, NY NPI 1083873319
- Lacey Anne Trimble, LCSWClinical Social Worker Port Jervis, NY NPI 1114086139
- Christine Smallin, LCSWClinical Social Worker Port Jervis, NY NPI 1144474461
- Victoria Caruso, LCSWRClinical Social Worker Port Jervis, NY NPI 1225178841
- Oscar James Lewis Jr., LCSW-R, PhDClinical Social Worker Port Jervis, NY NPI 1326364621
- Genevieve Clineman, LCSWClinical Social Worker Port Jervis, NY NPI 1366939662
About NPI 1750774741
Michael Jason Wickham, LCSW's National Provider Identifier is 1750774741, issued on Mar 14, 2015. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Port Jervis, NY. The record was last updated on Jul 22, 2026.