Individual provider Active NPI

Marc John Tremblay, LCSW

  • Clinical Social Worker
  • Albany, NY
National Provider Identifier
1184189417
Registry record updated Jan 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
075697 Issued in NY
Practice address
75 New Scotland Ave
Albany, NY 12208-3409
Phone
(518) 549-6500
Fax
(518) 549-6534
NPI assigned
Jan 31, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2019

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 075697 NY Primary

Addresses

Primary practice location

75 New Scotland Ave
Albany, NY 12208-3409

Mailing address

239 S Lake Ave
Troy, NY 12180-7010
Phone (518) 527-5024

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
075697NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1548892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548892800000",
    "number": "1184189417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 S LAKE AVE",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121807010",
            "telephone_number": "518-527-5024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 NEW SCOTLAND AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083409",
            "telephone_number": "518-549-6500",
            "fax_number": "518-549-6534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREMBLAY",
        "first_name": "MARC",
        "middle_name": "JOHN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-31",
        "last_updated": "2019-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "075697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2019; 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.