Amanda Rose Mazzone, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

088549 Issued in NY

Practice address

58 Richmond Blvd Unit 3B
Ronkonkoma, NY 11779-3405

Phone

(631) 885-2257

NPI assigned

May 15, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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, 2014

Medicare assignment

May accept Medicare assignment

Group practices

Janice Martin Licensed Clinical Social Worker PCGroup PAC ID 6305252537, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Janice Martin Licensed Clinical Social Worker PC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Port Jefferson, NY
  • NPI 1902427941
  Medicare reassignment Care Compare group NPD
• Community Counseling & LCSW Services PC

  • Clinical Social Worker
  • Center Moriches, NY
  • NPI 1770819690
  Medicare reassignment NPD
• Qureshi Medical Services PLLC

  • Psychiatry Physician
  • Center Moriches, NY
  • NPI 1316763162
  NPD (past)

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

{
    "created_epoch": "1431648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1497133979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 RICHMOND BLVD UNIT 3B",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117793405",
            "telephone_number": "631-885-2257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 RICHMOND BLVD UNIT 3B",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117793405",
            "telephone_number": "631-885-2257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZONE",
        "first_name": "AMANDA",
        "middle_name": "ROSE",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-15",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "72094788",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "088549",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02173802",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Lynette Mauldin
• Gail Maxwell, R.PH.
• Leann McCabe
• Brittnay Marie McCaffrey
• Julie McCloskey, RN
• Bryan K. McDonald, RN, BSN
• Eireann J McGrath, LAT, ATC

• Clinical Social Worker in Ronkonkoma, NY
• Providers in Ronkonkoma, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2023; 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.