Individual provider Active NPI

Maryjane Santeufemia, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1104416130
Registry record updated Jan 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R0239001 Issued in NY
Practice address
315 W 86TH St Apt 1D
New York, NY 10024-3108
Phone
(516) 236-8374
NPI assigned
Jan 23, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X
Clinical Social Worker 1041C0700X R0239001 NY Primary

Addresses

Primary practice location

315 W 86TH St Apt 1D
New York, NY 10024-3108

Mailing address

315 W 86TH St Apt 1D
New York, NY 10024-3108
Phone (516) 236-8374

Other identifiers 1

IdentifierTypeStateIssuer
R0239001OtherNYINSURANCE REIMBUSEMENT FOR LCSW

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL laptop

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
R0239001NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1611360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611360000000",
    "number": "1104416130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 W 86TH ST APT 1D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100243108",
            "telephone_number": "516-236-8374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 W 86TH ST APT 1D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100243108",
            "telephone_number": "516-236-8374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTEUFEMIA",
        "first_name": "MARYJANE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-23",
        "last_updated": "2021-01-23",
        "certification_date": "2021-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R0239001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INSURANCE REIMBUSEMENT FOR LCSW",
            "identifier": "R0239001",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "laptop",
            "affiliation": "N",
            "address_1": "315 W 86th St Apt 1D",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100243108",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.