Individual provider Active NPI

Marlene Serby, LCSW

  • Clinical Social Worker
  • Danbury, CT
National Provider Identifier
1326067463
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
001419 Issued in CT
Practice address
72 North St
Suite 205
Danbury, CT 06810-5648
Phone
(203) 794-1044
Fax
(203) 743-1110
NPI assigned
Jul 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 001419 CT Primary

Addresses

Primary practice location

72 North St
Suite 205
Danbury, CT 06810-5648

Mailing address

72 North St
Suite 205
Danbury, CT 06810-5648
Phone (203) 794-1044

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110822000068 CT Practitioner - Clinical Social Worker 9032389515 Reassigns benefits to 1 organization
Practice locations: Wilton, CT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3 Hollyhock Rd
Wilton, CT 06897-4443
Phone (203) 846-8287

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001419CTMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological Health Associates LLC Clinical CurrentSince Aug 1, 2011 Accepting new patients

Locations

701 Cottage Grove Rd
Ste C210
Bloomfield, CT 06002
Phone (860) 233-9772

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326067463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72 NORTH ST",
            "address_2": "SUITE 205",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068105648",
            "telephone_number": "203-794-1044",
            "fax_number": "203-743-1110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 NORTH ST",
            "address_2": "SUITE 205",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068105648",
            "telephone_number": "203-794-1044",
            "fax_number": "203-743-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERBY",
        "first_name": "MARLENE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "001419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danbury, CT

Sources for this page

Verify at the official NPI Registry.