Individual provider Active NPI

Jacinta Lu Marschke, PH.D., LICSW

  • Clinical Social Worker
  • New Paltz, NY
National Provider Identifier
1174693147
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
11941 Issued in NY
Practice address
243 Main St
#70
New Paltz, NY 12561-1325
Phone
(845) 255-5466
NPI assigned
Nov 8, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 11941 NY Primary

Addresses

Primary practice location

243 Main St
#70
New Paltz, NY 12561-1325

Mailing address

243 Main St
#70
New Paltz, NY 12561-1325
Phone (845) 255-5466

Other identifiers 1

IdentifierTypeStateIssuer
01940858MedicaidNY

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
I20100305000530 NY Practitioner - Clinical Social Worker 7416092127 Practice locations: Kingston, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

109 Whiteport Rd
Kingston, NY 12401-8665
Phone (845) 649-4644

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
11941NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174693147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 MAIN ST",
            "address_2": "#70",
            "city": "NEW PALTZ",
            "state": "NY",
            "postal_code": "125611325",
            "telephone_number": "845-255-5466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243 MAIN ST",
            "address_2": "#70",
            "city": "NEW PALTZ",
            "state": "NY",
            "postal_code": "125611325",
            "telephone_number": "845-255-5466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSCHKE",
        "first_name": "JACINTA",
        "middle_name": "LU",
        "name_prefix": "Dr.",
        "credential": "PH.D., LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "11941",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01940858",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Paltz, NY

Sources for this page

Verify at the official NPI Registry.