Individual provider Active NPI

Marjorie E. Berman, LCSW-R

  • Clinical Social Worker
  • Woodstock, NY
National Provider Identifier
1437216819
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R053809-1 Issued in NY
Practice address
133 Tinker St
First Floor
Woodstock, NY 12498-1143
Phone
(845) 679-1260
NPI assigned
Jan 3, 2007
Sex
Female
Sole proprietor
Yes

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 R053809-1 NY Primary

Addresses

Primary practice location

133 Tinker St
First Floor
Woodstock, NY 12498-1143

Mailing address

133 Tinker St
First Floor
Woodstock, NY 12498-1143
Phone (845) 679-1260

Other identifiers 1

IdentifierTypeStateIssuer
02534816MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20040416001199 NY Practitioner - Clinical Social Worker 4981699147 Practice locations: Woodstock, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

9 Knolls CT
Woodstock, NY 12498-1742
Phone (845) 679-1260

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R053809-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437216819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 TINKER ST",
            "address_2": "FIRST FLOOR",
            "city": "WOODSTOCK",
            "state": "NY",
            "postal_code": "124981143",
            "telephone_number": "845-679-1260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 TINKER ST",
            "address_2": "FIRST FLOOR",
            "city": "WOODSTOCK",
            "state": "NY",
            "postal_code": "124981143",
            "telephone_number": "845-679-1260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERMAN",
        "first_name": "MARJORIE",
        "middle_name": "E.",
        "name_prefix": "Ms.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R053809-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02534816",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, NY

Sources for this page

Verify at the official NPI Registry.