Active NPI
Andrea Marjason
- Clinical Social Worker
- Longview, TX
National Provider Identifier
1104281518
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 56436
- Practice address
- 1300 N 6TH St
Longview, TX 75601-5567 - Phone
- (903) 297-1852
- NPI assigned
- Dec 30, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 56436 | TX | Primary |
Addresses
Primary practice location
1300 N 6TH St
Longview, TX 75601-5567
Mailing address
124 Rutland Dr
Hallsville, TX 75650-6213
Phone (903) 736-6818
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 56436 | Other | TX | TEXAS STATE BOARD OF SOCIAL WORKER EXAMINERS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1451433600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1451433600000",
"number": "1104281518",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "124 RUTLAND DR",
"city": "HALLSVILLE",
"state": "TX",
"postal_code": "756506213",
"telephone_number": "903-736-6818"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 N 6TH ST",
"city": "LONGVIEW",
"state": "TX",
"postal_code": "756015567",
"telephone_number": "903-297-1852"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARJASON",
"first_name": "ANDREA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-12-30",
"last_updated": "2015-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "56436",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TEXAS STATE BOARD OF SOCIAL WORKER EXAMINERS",
"identifier": "56436",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Longview, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.