Mary Lee Hasbrouck, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R022772-1 Issued in NY

Practice address

45 Route 25a Ste A2
Shoreham, NY 11786-1389

Phone

(631) 821-5056

Fax

(631) 821-5056

NPI assigned

Aug 31, 2006

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

Other identifiers 1

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

Specialty

Clinical Social Worker

Education

Other, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles (1 of 5)

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989

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.

• Shoreham Psychotherapy Services LCSW PLLC

  • Clinical Social Worker
  • Shoreham, NY
  • NPI 1669860573

  Clinical

  NPD (past) Authorized official

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457463598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 ROUTE 25A STE A2",
            "city": "SHOREHAM",
            "state": "NY",
            "postal_code": "117861389",
            "telephone_number": "631-821-5056",
            "fax_number": "631-821-5056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 ROUTE 25A STE A2",
            "city": "SHOREHAM",
            "state": "NY",
            "postal_code": "117861389",
            "telephone_number": "631-821-5056",
            "fax_number": "631-821-5056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASBROUCK",
        "first_name": "MARY LEE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R022772-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01475396",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gary P Milack DPM PC
• Diane Gavares, LCSW
• Lee Anne Griffin, M.A. CCC SLP
• Chris Gary Grzymala, P.T.
• Jennifer Guido, LMT
• Lori Ann Hegel, P.T.
• Emily Hennessey, LMSW
• Charles Richard Hoeg Jr., DMD
• Paige Marie Hoffman
• Eric Hoffmann, M.D.

• All providers in Shoreham, NY
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.