Active NPI
Mary Ann Worthington, PH.D.
- Psychologist
- Patchogue, NY
National Provider Identifier
1235495573
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 68013890
- Practice address
- 241 South Ocean Avenue
Patchogue Medford School District
Patchogue, NY 11772 - Phone
- (631) 687-6440
- NPI assigned
- Apr 11, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 68013890 | NY | Primary |
Addresses
Primary practice location
241 South Ocean Avenue
Patchogue Medford School District
Patchogue, NY 11772
Mailing address
241 South Ocean Avenue
Patchogue Medford School District
Patchogue, NY 11772
Phone (631) 687-6440
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 68013890 | NY | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Patchogue-Medford School District | Past | Accepting new patients | |
| Patchogue-Medford School District | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- School Social Worker
- Medford, NY
- NPI 1003174020
-
- School Social Worker
- Medford, NY
- NPI 1790047694
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1334102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1334102400000",
"number": "1235495573",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "241 SOUTH OCEAN AVENUE",
"address_2": "PATCHOGUE MEDFORD SCHOOL DISTRICT",
"city": "PATCHOGUE",
"state": "NY",
"postal_code": "11772",
"telephone_number": "631-687-6440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "241 SOUTH OCEAN AVENUE",
"address_2": "PATCHOGUE MEDFORD SCHOOL DISTRICT",
"city": "PATCHOGUE",
"state": "NY",
"postal_code": "11772",
"telephone_number": "631-687-6440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WORTHINGTON",
"first_name": "MARY",
"middle_name": "ANN",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-04-11",
"last_updated": "2012-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "68013890",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Patchogue, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.