Maureen Coley, LCSW
Individual provider Active NPI Clinical Social Worker · Southampton, NY
NPI 1376606368 · NPPES record last updated Oct 4, 2007
Key facts
- NPI
- 1376606368
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- R046352 (NY)
- Practice address
- 335 Meeting House LN # B
Southampton, NY 11968-5051 - Phone
- (631) 287-5990
- Fax
- (631) 287-5995
- NPI assigned
- Dec 19, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Valley Medical Group-Renton
Practice addresses (Care Compare)
3915 Talbot Rd S
Suite 200
Renton, WA 98055-5738
Phone (425) 690-3400
Hospital & facility affiliations
- Valley Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NY, WA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230208003159 | NY | Practitioner - Clinical Social Worker | 9638260631 | |
| I20240618003835 | WA | Practitioner - Clinical Social Worker | 9638260631 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R046352 | NY | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Meeting House Lane Medical Practice PC | Current |
Accepting new patients | |
| Valley Medical Group-Renton | Current |
Accepting new patients | |
| University Hospital at Stony Brook | Past | Accepting new patients |
Locations
182 W Montauk Hwy
Ste D
Hampton Bays, NY 11946
Phone (631) 287-5990
182 W Montauk Hwy
Ste B
Hampton Bays, NY 11946
Phone (631) 594-3910
325 Meeting House Ln
Ste 403
Southampton, NY 11968
Phone (631) 283-2100
16850 SE 272nd St
Ste 100
Covington, WA 98042
Phone (253) 395-1971
3915 Talbot Rd S
Ste 200
Renton, WA 98055
Phone (425) 658-5566
3600 Lind Ave SW
Ste 100
Renton, WA 98057
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | R046352 | NY | Yes |
Addresses
Primary practice location
335 Meeting House LN # B
Southampton, NY 11968-5051
Mailing address
83 Seville Blvd
Sayville, NY 11782-2112
Phone (631) 563-5130
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| R046352 | Other | NY | HIP |
Other providers in Southampton, NY
- Michael Colin Coard II
- Julie Codrington
- Andrew Cohen
- Harriet M Cohen
- Sarah J Cohen
- Comprehensive Psychology Services PLLC
- Sarah Connors
- Gina Marie Constantine
- Michael Berty Cordero
- Corwith Pharmacy Inc
All providers in Southampton, NY · Clinical Social Worker in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 4, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.