Mara Nellis, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

072722-1 Issued in NY

Practice address

161 W 54TH St
Apt 202
New York, NY 10019-5454

Phone

(212) 252-2116

NPI assigned

Apr 3, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Oct 12, 2023 through Oct 12, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Comunilife-Oasis Guidance Center

  • Community/Behavioral Health Agency
  • Bronx, NY
  • NPI 1407023138
  NPD (past)
• Comunilife, Inc.

  • Voluntary or Charitable Agency
  • Bronx, NY
  • NPI 1528082013
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1003878331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 W 54TH ST",
            "address_2": "APT 202",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100195454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 W 54TH ST",
            "address_2": "APT 202",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100195454",
            "telephone_number": "212-252-2116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELLIS",
        "first_name": "MARA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-03",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "072722-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madeline Nelkin, LMSW
• Marita Nell-Daniels, RN
• Kate Wilkins Nellans, MD
• Danielle Nelle
• Matthew Nelligan, MD
• Marianne Nellis, MD
• Nelly Sta Maria Psychologist
• Nelly T. Loo M.D., P.C.
• Christine E. Nelsen
• Keimoy Nelson-Johnson, FNP-BC

• Clinical Social Worker in New York, NY
• Providers in New York, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.