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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

MICHAEL JASON WICKHAM LCSW
NPI 1750774741
Social Worker - Clinical in Port Jervis, NY

Active since March 14, 2015
146 PIKE STREET, PORT JERVIS, NY 12771(845) 858-1456(845) 378-3283 Get Directions Write a Review

NPPES record last updated: July 22, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Michael Jason Wickham Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MICHAEL JASON WICKHAM LCSW (NPI 1750774741) is an individual clinical provider in Port Jervis, New York, licensed in New York (095201-01) and active in the NPI registry since March 2015.

NPPES Registry Identity

NPI1750774741
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameMICHAEL JASON WICKHAMCredential: LCSW
Location Address146 PIKE STREETPort Jervis, NY 12771-1939
Mailing Address118 Glenmere AveFlorida, NY 10921-1210 · (845) 741-9399
Phone(845) 858-1456
Fax(845) 378-3283
Sole ProprietorYes
Enumeration DateMarch 14, 2015
Last NPPES UpdateJuly 22, 2026
NPPES CertifiedJuly 22, 2026
✔ NPI 1750774741 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Licenses✔ Licensed in NY · 095201-01✔ Licensed in KY · 257898✔ Licensed in NJ · 44SC05923700
Definition
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.
146 PIKE STREET, Port Jervis, NY 12771
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Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. CHRISTINE SMALLIN LCSW
Social Worker (Clinical)
146 PIKE STREET
PORT JERVIS, NY 12771
Orange County (845) 858-1456
MS. LILLIAN ROTHENHAUS
Counselor (Mental Health)
146 PIKE STREET
PORT JERVIS, NY 12771
Orange County (845) 858-1456
MARTHA MCPHAIL THOMSON NP
Nurse Practitioner (Psychiatric/Mental Health)
146 PIKE STREET
PORT JERVIS, NY 12771
Orange County (845) 858-1456
MR. PHILLIP WHAYNE BENNETT LCSW
Social Worker (Clinical)
146 PIKE STREET
PORT JERVIS, NY 12771
Orange County (845) 858-1456
COUNTY OF ORANGE
Clinic/Center (Mental Health (Including Community Mental Health Center))
146 PIKE STREET
PORT JERVIS, NY 12771
Orange County (845) 858-1456

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Michael Wickham's NPI number?

The NPI number for Michael Wickham is 1750774741. It was assigned to this individual provider in the NPPES registry on March 14, 2015.

Where is Michael Wickham located?

Michael Wickham practices at 146 Pike Street, Port Jervis, NY 12771. The listed phone number is (845) 858-1456.

What is Michael Wickham's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for Michael Wickham was last updated on July 22, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.