Active NPI
Marilyn Maldonado, LMSW
- Clinical Social Worker
- Corona, NY
National Provider Identifier
1134639602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 100806
- Practice address
- 4035 Junction Blvd
Corona, NY 11368-2121 - Phone
- (917) 995-3773
- Fax
- (212) 656-1412
- NPI assigned
- Oct 10, 2017
- 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 | 100806 | NY | Primary |
Addresses
Primary practice location
4035 Junction Blvd
Corona, NY 11368-2121
Mailing address
78-08 151 Avenue
2ND Floor
Howard Beach, NY 11414
Phone (347) 351-3919
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
| License | State | Type | Specialty |
|---|---|---|---|
| 100806 | NY | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Support Evaluation and Intervention Services LCSW P.C | Clinical | 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.
-
- Clinical Social Worker
- Corona, NY
- NPI 1790185395
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1507593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1507593600000",
"number": "1134639602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "78-08 151 AVENUE",
"address_2": "2ND FLOOR",
"city": "HOWARD BEACH",
"state": "NY",
"postal_code": "11414",
"telephone_number": "347-351-3919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4035 JUNCTION BLVD",
"city": "CORONA",
"state": "NY",
"postal_code": "113682121",
"telephone_number": "917-995-3773",
"fax_number": "212-656-1412"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALDONADO",
"first_name": "MARILYN",
"name_prefix": "Ms.",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-10-10",
"last_updated": "2017-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "100806",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corona, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.