Marc Etts, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

094225-01 Issued in NY

Practice address

15 Standish PL
Nesconset, NY 11767-1719

Phone

(631) 357-0592

NPI assigned

Aug 28, 2016

Sex

Male

Sole proprietor

Yes

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

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Aid to the Developmentally Disabled IncGroup PAC ID 1658762182, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Aid to the Developmentally Disabled, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Riverhead, NY
  • NPI 1912575762

  NY

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1472342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1013463231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 STANDISH PL",
            "city": "NESCONSET",
            "state": "NY",
            "postal_code": "117671719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 STANDISH PL",
            "city": "NESCONSET",
            "state": "NY",
            "postal_code": "117671719",
            "telephone_number": "631-357-0592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETTS",
        "first_name": "MARC",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-28",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "094225-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Drury, M.A. CCC-SLP
• Ear Works Audiology PC
• Lorie Echerer-Vanriel, P.T.
• Rhonda R Edwards-Braithwaite, PA
• Tina M Elderbaum, P.T.
• Excel Urgent Care of Nesconset, PLLC
• Eye Vision Associates, LLP
• Sharon Eye, LPN
• Donna Fade, RN
• Jovite Fequiere, N.A

• All providers in Nesconset, NY
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.