Marxlenin Burgos, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC05960800 Issued in NJ

Practice address

39 Struyk Ave Apt 1
Prospect Park, NJ 07508-2232

Phone

(973) 830-9720

NPI assigned

Dec 7, 2020

Last updated

Apr 9, 2024By the provider in NPPES

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 NJ

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Supportive Care Psychology of NJ PC

  • Clinical Psychologist
  • Howell, NJ
  • NPI 1356840003
  Medicare reassignment NPD
• PHC of Buffalo Grove Clinical Psychology

  dba Portrait Health Centers

  • Psychologist
  • Vernon Hills, IL
  • NPI 1235430612
  NPD (past)

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

{
    "created_epoch": "1607299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1467058479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 STRUYK AVE APT 1",
            "city": "PROSPECT PARK",
            "state": "NJ",
            "postal_code": "075082232",
            "telephone_number": "973-830-9720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 STRUYK AVE APT 1",
            "city": "PROSPECT PARK",
            "state": "NJ",
            "postal_code": "075082232",
            "telephone_number": "973-830-9720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGOS",
        "first_name": "MARXLENIN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-07",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05960800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Auxiliary Home Care
• Eyad Y Baghal, M.D.
• Mariam Beshara, DMD
• Deneshia Alethia Branford-Wright, APN
• Buckingham Adult Medical Day Care Center LLC
• Benedicto Ramirez Cabungcal
• Jazmin Cascante, APN
• Certified Medical Transportation L.L.C
• Kayla Cintron
• Dawa Pharmacy LLC (Dawa Pharmacy)

• Clinical Social Worker in Prospect Park, NJ
• Providers in Prospect Park, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.