Individual provider Active NPI

Marsha Moise, LCSW

  • Clinical Social Worker
  • Jamaica, NY
National Provider Identifier
1023759412
Registry record updated Dec 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
098971 Issued in NY
Practice address
8268 164TH St
Jamaica, NY 11432-1121
Phone
(718) 883-2718
NPI assigned
Apr 7, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 31, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 104100000X 113429 NY
Clinical Social Worker 1041C0700X 098971 NY Primary

Addresses

Primary practice location

8268 164TH St
Jamaica, NY 11432-1121

Mailing address

134 N 4TH St
Brooklyn, NY 11249-3296
Phone (646) 450-7748

Other practice location 1

134 N 4th St
Brooklyn, NY 11249-3296
Phone (646) 450-7748

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: No
  • 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
I20250416001320 NY Order and Referring Only - Clinical Social Worker 8820513435

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
113429NYMDSocial Worker

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

NPI Registry JSON

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

{
    "created_epoch": "1649289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735603200000",
    "number": "1023759412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 N 4TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112493296",
            "telephone_number": "646-450-7748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8268 164TH ST",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114321121",
            "telephone_number": "718-883-2718"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "134 N 4th St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112493296",
            "country_code": "US",
            "telephone_number": "646-450-7748",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOISE",
        "first_name": "MARSHA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-07",
        "last_updated": "2024-12-31",
        "certification_date": "2024-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": "NY",
            "license": "113429",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "098971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

Verify at the official NPI Registry.