Individual provider Active NPI

Rebecca King-Marks, LCSWA

  • Clinical Social Worker
  • Cary, NC
National Provider Identifier
1265000236
Registry record updated Jun 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P016067 Issued in NY
Practice address
130 Iowa LN Ste 102
Cary, NC 27511-2401
Phone
(516) 589-4179
NPI assigned
Jun 15, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 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 P016067 NY Primary

Addresses

Primary practice location

130 Iowa LN Ste 102
Cary, NC 27511-2401

Mailing address

627 Berwick Valley LN
Cary, NC 27513-3297
Phone (516) 589-4179

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
P016067NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mona R Gupta, DO Incorporated Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1623715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1265000236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "627 BERWICK VALLEY LN",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275133297",
            "telephone_number": "516-589-4179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 IOWA LN STE 102",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275112401",
            "telephone_number": "516-589-4179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING-MARKS",
        "first_name": "REBECCA",
        "name_prefix": "Mrs.",
        "credential": "LCSWA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-15",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "P016067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2021; 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.