Individual provider Active NPI

Marisa Bolognini

  • Clinical Social Worker
  • Tallahassee, FL
National Provider Identifier
1023626041
Registry record updated Mar 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
2600 Centennial PL Ste 200
Tallahassee, FL 32308-0583
Phone
(850) 431-5105
NPI assigned
Jul 15, 2020
Last updated
Mar 27, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

2600 Centennial PL Ste 200
Tallahassee, FL 32308-0583

Mailing address

PO Box 748967
Atlanta, GA 30374-8967
Phone (850) 431-7289

Other practice location 1

6309 Mack Ave
Detroit, MI 48207-2302
Phone (313) 331-3435

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20260407004274 FL Practitioner - Clinical Social Worker 4981179900 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1607 Saint James CT
Tallahassee, FL 32308-4658

PO Box
Atlanta, GA 30374

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1594771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774569600000",
    "number": "1023626041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 748967",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303748967",
            "telephone_number": "850-431-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 CENTENNIAL PL STE 200",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323080583",
            "telephone_number": "850-431-5105"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6309 Mack Ave",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482072302",
            "country_code": "US",
            "telephone_number": "313-331-3435",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLOGNINI",
        "first_name": "MARISA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-15",
        "last_updated": "2026-03-27",
        "certification_date": "2026-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.