Individual provider Active NPI

Marissa Lynn McDermit, LSW

  • Clinical Social Worker
  • Mill Hall, PA
National Provider Identifier
1487081980
Registry record updated Oct 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW026582 Issued in PA
Practice address
7932 Nittany Valley Dr
Mill Hall, PA 17751-8805
Phone
(570) 726-4592
Fax
(570) 726-4082
NPI assigned
Sep 30, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2025

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 CW026582 PA Primary

Addresses

Primary practice location

7932 Nittany Valley Dr
Mill Hall, PA 17751-8805

Mailing address

663 Bellefonte Ave Apt 2
Lock Haven, PA 17745-2433

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20251202001858 PA Practitioner - Clinical Social Worker 2163915893 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiance Wellness Group LLC 5 clinicians

Practice addresses (Care Compare)

1341 E 3Rd St
Williamsport, PA 17701-5409
Phone (570) 601-4325

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CW026582PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Radiance Wellness Group LLC CurrentSince Oct 8, 2025 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1380499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760227200000",
    "number": "1487081980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "663 BELLEFONTE AVE APT 2",
            "city": "LOCK HAVEN",
            "state": "PA",
            "postal_code": "177452433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7932 NITTANY VALLEY DR",
            "city": "MILL HALL",
            "state": "PA",
            "postal_code": "177518805",
            "telephone_number": "570-726-4592",
            "fax_number": "570-726-4082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDERMIT",
        "first_name": "MARISSA",
        "middle_name": "LYNN",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-30",
        "last_updated": "2025-10-12",
        "certification_date": "2025-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW026582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mill Hall, PA

Sources for this page

Verify at the official NPI Registry.