Marissa Maciel, LSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

33006766A Issued in IN

Practice address

601 Wall St
Valparaiso, IN 46383-2512

Phone

(219) 531-3500

NPI assigned

Jan 15, 2014

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN, FL2 enrollments

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 2

Specialty

Clinical Social Worker

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Brandon Mental HealthGroup PAC ID 8527136977, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Brandon Mental Health

  • Community/Behavioral Health Agency
  • Brandon, FL
  • NPI 1649421389
  Medicare reassignment Care Compare group NPD
• Porter-Starke Services Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Valparaiso, IN
  • NPI 1689627598
  Medicare reassignment NPD
• Porter-Starke Services Inc.

  • Federally Qualified Health Center (FQHC)
  • Valparaiso, IN
  • NPI 1659196236
  NPD

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

{
    "created_epoch": "1389744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620864000000",
    "number": "1437571171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1134 BELL SHOALS RD",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335118813",
            "telephone_number": "219-531-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 WALL ST",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463832512",
            "telephone_number": "219-531-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACIEL",
        "first_name": "MARISSA",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-15",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "33006766A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Christopher Lynam, D.O.
• Anna Lynch, MSW
• Kristen Marie Lynch, FNP-C
• William Arthur Lyzak Jr., DMD
• Gregory Scott Macdonald, DDS
• Stephanie Paige Maddex, LCSW
• Jane Christine Maddox, NP
• Andrea Madrid
• Magdalena Maria Maginot
• Steven David Magura, DDS

• Social Worker in Valparaiso, IN
• Providers in Valparaiso, IN by specialty
• Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.