Individual provider Active NPI

Erik Marks, LICSW

  • Clinical Social Worker
  • Somerville, MA
National Provider Identifier
1104930247
Registry record updated Aug 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
110882 Issued in MA
Practice address
403 Highland Ave Ste 211
Somerville, MA 02144-2530
Phone
(617) 448-9916
Fax
(855) 739-4903
NPI assigned
Aug 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 110882 MA Primary

Addresses

Primary practice location

403 Highland Ave Ste 211
Somerville, MA 02144-2530

Mailing address

872 Mass Ave
Suite 2-1
Cambridge, MA 02139-3073
Phone (617) 448-9916

Other identifiers 1

IdentifierTypeStateIssuer
1859374MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20040608000594 MA Practitioner - Clinical Social Worker 2062495450 Practice locations: Cambridge, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

872 Massachusetts
Suite 1
Cambridge, MA 02139-3072
Phone (617) 448-9916

872 Massachusetts Ave
Suite 2 1
Cambridge, MA 02139-3072

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
110882MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Nora Ilniczky, PH.D., Psychotherapy and Wellbeing, LLC. Past Accepting new patients

Organizations & group practices 1

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": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754006400000",
    "number": "1104930247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "872 MASS AVE",
            "address_2": "SUITE 2-1",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021393073",
            "telephone_number": "617-448-9916",
            "fax_number": "855-739-4903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 HIGHLAND AVE STE 211",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021442530",
            "telephone_number": "617-448-9916",
            "fax_number": "855-739-4903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKS",
        "first_name": "ERIK",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2025-08-01",
        "certification_date": "2025-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "110882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1859374",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerville, MA

Sources for this page

Verify at the official NPI Registry.