Mary R. Desimone, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R056267 Issued in NY

Practice address

430 W Main St
Suite B
Babylon, NY 11702-3003

Phone

(631) 647-5423

Fax

(631) 647-5423

NPI assigned

Nov 15, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Miss Mary R. Grillo Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191974400000",
    "number": "1215000799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 FREEMAN AVE",
            "city": "ISLIP",
            "state": "NY",
            "postal_code": "117511418",
            "telephone_number": "631-968-8838",
            "fax_number": "631-647-5423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 W MAIN ST",
            "address_2": "SUITE B",
            "city": "BABYLON",
            "state": "NY",
            "postal_code": "117023003",
            "telephone_number": "631-647-5423",
            "fax_number": "631-647-5423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESIMONE",
        "first_name": "MARY",
        "middle_name": "R.",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R056267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "GRILLO",
            "middle_name": "R.",
            "prefix": "MISS",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Giancarlo De Carolis, M.D.
• Regina Margaret De Witt, R.N.
• Barbara Ann Defeo, LPN
• Sarah Demilt
• Dental Expediting Services, LLC
• Saila Detore, D.O.
• Jennifer Devereau
• Christina Diana, RDN
• Theresa Diorio
• Justin Discalfani, PH.D., BCBA-D

• Clinical Social Worker in Babylon, NY
• Providers in Babylon, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2007; 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.