Individual provider Active NPI

Risa B Marlen, LCSW

  • Clinical Social Worker
  • Teaneck, NJ
National Provider Identifier
1306854427
Registry record updated Oct 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SC04903 Issued in NJ
Practice address
538 Beverly Rd
Teaneck, NJ 07666-1826
Phone
(201) 836-3462
NPI assigned
Aug 4, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2008

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 SC04903 NJ Primary

Addresses

Primary practice location

538 Beverly Rd
Teaneck, NJ 07666-1826

Mailing address

538 Beverly Rd
Teaneck, NJ 07666-1826
Phone (201) 741-6056

Other identifiers 3

IdentifierTypeStateIssuer
R014995-1OtherNYR-CSW
SC04903OtherNJLICENSE CLINICAL SW
11234845OtherCAQH

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC04903NJMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225238400000",
    "number": "1306854427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "538 BEVERLY RD",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076661826",
            "telephone_number": "201-741-6056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "538 BEVERLY RD",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076661826",
            "telephone_number": "201-836-3462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARLEN",
        "first_name": "RISA",
        "middle_name": "B",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2008-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "SC04903",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R-CSW",
            "identifier": "R014995-1",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE CLINICAL SW",
            "identifier": "SC04903",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11234845",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Teaneck, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2008; 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.