Mary Lerouge LCSW PLLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

MARY LEROUGE LCSW PLLC

Practice address

720 Route 17M
Middletown, NY 10940-4346

Phone

(845) 391-3812

NPI assigned

Sep 15, 2020

Organization subpart

No

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

Authorized official

Name

Mary Lerouge, LCSWNPI 1700254349

Title

Owner

Phone

(845) 551-6534

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 2

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

• Mary Lerouge, LCSW PLLC

  • Mental Health Counselor
  • Middletown, NY
  • NPI 1700254349
  Medicare reassignment NPD Authorized official
• David Joseph Miranda, LCSW

  • Clinical Social Worker
  • Goshen, NY
  • NPI 1639300825
  NPD (past)

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

{
    "created_epoch": "1600128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678233600000",
    "number": "1043825029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 SPROAT ST",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109403713",
            "telephone_number": "845-551-6534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 ROUTE 17M",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109404346",
            "telephone_number": "845-391-3812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY LEROUGE LCSW PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-15",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A",
        "authorized_official_last_name": "LEROUGE",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "845-551-6534",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Stephanie Elaine Martir
• Richard M Martirosian, D.O.
• Cecilia C Mary
• Michael Max Mascola, DO
• Christine Masella
• Andrea Mason
• Naomi A Mason, BA, OSC

• Mental Health Counselor in Middletown, NY
• Providers in Middletown, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.