Active NPI
Crystal Marr
- Clinical Social Worker
- Newburgh, NY
National Provider Identifier
1487068839
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 077558
- Practice address
- 147 Lake St
Newburgh, NY 12550-5263 - Phone
- (845) 563-8000
- Fax
- (845) 565-1731
- NPI assigned
- Jun 13, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 077558 | NY | Primary |
Addresses
Primary practice location
147 Lake St
Newburgh, NY 12550-5263
Mailing address
147 Lake St
Newburgh, NY 12550-5263
Phone (845) 563-8000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 077558 | NY | MD | Clinical Social Worker |
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1402617600000",
"number": "1487068839",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "147 LAKE ST",
"city": "NEWBURGH",
"state": "NY",
"postal_code": "125505263",
"telephone_number": "845-563-8000",
"fax_number": "845-565-1731"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "147 LAKE ST",
"city": "NEWBURGH",
"state": "NY",
"postal_code": "125505263",
"telephone_number": "845-563-8000",
"fax_number": "845-565-1731"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARR",
"first_name": "CRYSTAL",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-06-13",
"last_updated": "2014-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "077558",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newburgh, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.