Individual provider Active NPI

Marisel Lopez, LMSW

  • Social Worker
  • Amityville, NY
National Provider Identifier
1063956993
Registry record updated Jul 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
1080 Sunrise Hwy
Amityville, NY 11701
Phone
(631) 450-9041
NPI assigned
Dec 12, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

1080 Sunrise Hwy
Amityville, NY 11701

Mailing address

1080 Sunrise Hwy
Amityville, NY 11701-2526
Phone (631) 450-9026

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20241209000527 NY Practitioner - Clinical Social Worker 8820524366 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
098305NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Harmony Health Care Long Island Current Accepting new patients
Harmony Health Care Long Island CurrentSince Oct 4, 2024 Accepting new patients
Harmony Health Care Long Island CurrentSince Oct 4, 2024 Accepting new patients
Psychotherapy at Home, LCSW, PLLC CurrentSince Jan 26, 2026 Accepting new patients

Locations

400 Oak St
Ste 104
Garden City, NY 11530
Phone (516) 485-5876

135 Main St
Hempstead, NY 11550
Phone (516) 292-3111

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1481500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532649600000",
    "number": "1063956993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1080 SUNRISE HWY",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117012526",
            "telephone_number": "631-450-9026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1080 SUNRISE HWY",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "11701",
            "telephone_number": "631-450-9041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "MARISEL",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-12",
        "last_updated": "2018-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amityville, NY

Sources for this page

Verify at the official NPI Registry.