Individual provider Active NPI

Stacey Lee Marando, LMSW

  • Social Worker
  • Miller Place, NY
National Provider Identifier
1114164019
Registry record updated Jan 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
065248-1 Issued in NY
Practice address
4 Stratford Rd
Miller Place, NY 11764-1926
Phone
(631) 642-3866
NPI assigned
Jan 14, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2009

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 065248-1 NY Primary

Addresses

Primary practice location

4 Stratford Rd
Miller Place, NY 11764-1926

Mailing address

4 Stratford Rd
Miller Place, NY 11764
Phone (631) 642-3866

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
065248-1NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1231891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231891200000",
    "number": "1114164019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 STRATFORD RD",
            "city": "MILLER PLACE",
            "state": "NY",
            "postal_code": "11764",
            "telephone_number": "631-642-3866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 STRATFORD RD",
            "city": "MILLER PLACE",
            "state": "NY",
            "postal_code": "117641926",
            "telephone_number": "631-642-3866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARANDO",
        "first_name": "STACEY",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-14",
        "last_updated": "2009-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "065248-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miller Place, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2009; 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.