Marcus Self Discovery Group LLC

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Legal business name

MARCUS SELF DISCOVERY GROUP LLC

Practice address

2203 W Liberty St
Allentown, PA 18104-4323

Phone

(484) 840-6929

NPI assigned

Jun 13, 2020

Organization subpart

No

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

Authorized official

Name

Mr. Harry Shane FalwellNPI 1902420425

Title

Founder/Ceo

Phone

(484) 840-6929

Specialties & licenses 7

Addresses

Electronic endpoints 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Harry Shane Falwell

  • Peer Specialist
  • Allentown, PA
  • NPI 1902420425
  NPD Authorized official

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

{
    "created_epoch": "1592006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592006400000",
    "number": "1013532266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2203 W LIBERTY ST",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181044323",
            "telephone_number": "484-840-6929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2203 W LIBERTY ST",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181044323",
            "telephone_number": "484-840-6929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARCUS SELF DISCOVERY GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-13",
        "last_updated": "2020-06-13",
        "certification_date": "2020-06-13",
        "status": "A",
        "authorized_official_last_name": "FALWELL",
        "authorized_official_first_name": "HARRY",
        "authorized_official_middle_name": "SHANE",
        "authorized_official_title_or_position": "FOUNDER/CEO",
        "authorized_official_telephone_number": "484-840-6929",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "177F00000X",
            "taxonomy_group": "",
            "desc": "Lodging",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "marcusselfdiscoverygroup.net@gmail.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2203 W Liberty St",
            "city": "Allentown",
            "state": "PA",
            "country_code": "US",
            "postal_code": "181044323",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lisa Marie Manzo, LCSW
• Holly Brader Marakovits, CRNP
• Patricia Maran, M.D.
• Marc Berson and Monica Martocci LLP
• Angela M. Marchetto, M.S.
• Norman H Marcus, M.D.
• Sevasti Peter Margetas, D.O.
• Rachel S Margetis, BA
• James K Margolis, PH.D.
• Meredith Robins Margolis, PH.D.

• Case Manager/Care Coordinator in Allentown, PA
• Providers in Allentown, PA by specialty
• Case Manager/Care Coordinator in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.