Individual provider Active NPI

Marina Roux, LCSW-R

  • Clinical Social Worker
  • Center Moriches, NY
National Provider Identifier
1144316076
Registry record updated Oct 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
071373-1 Issued in NY
Practice address
408 Main St Ste 3
Center Moriches, NY 11934-3523
Phone
(631) 874-0185
NPI assigned
Oct 5, 2006
Last updated
Oct 7, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2021

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 071373-1 NY Primary

Addresses

Primary practice location

408 Main St Ste 3
Center Moriches, NY 11934-3523

Mailing address

408 Main Street South Ste 3
Center Moriches, NY 11934
Phone (631) 874-0185

Other practice location 1

234 Main St
Center Moriches, NY 11934-3515
Phone (631) 874-0185

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20040506001091 NY Practitioner - Clinical Social Worker 8426047465 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
State University of New York at Stony Brook, School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Counseling and LCSW ServicesGroup PAC ID 3577605617, 17 clinicians

Practice addresses (Care Compare)

234 Main St
Center Moriches, NY 11934-3514
Phone (631) 874-0185

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071373-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Qureshi Medical Services PLLC CurrentSince Dec 1, 2024 Accepting new patients

Locations

234 Montauk Hwy
Ctr Moriches, NY 11934
Phone (631) 874-0185

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633564800000",
    "number": "1144316076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 MAIN STREET SOUTH STE 3",
            "city": "CENTER MORICHES",
            "state": "NY",
            "postal_code": "11934",
            "telephone_number": "631-874-0185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 MAIN ST STE 3",
            "city": "CENTER MORICHES",
            "state": "NY",
            "postal_code": "119343523",
            "telephone_number": "631-874-0185"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "234 Main St",
            "address_purpose": "LOCATION",
            "city": "Center Moriches",
            "state": "NY",
            "postal_code": "119343515",
            "country_code": "US",
            "telephone_number": "631-874-0185",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROUX",
        "first_name": "MARINA",
        "credential": "LCSW-R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "071373-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Center Moriches, NY

Sources for this page

Verify at the official NPI Registry.