Emily Ann Passik, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

18111198-01 Issued in NY

Practice address

404 Zena Rd
Woodstock, NY 12498-2626

Phone

(845) 679-8650

Fax

(845) 679-5485

NPI assigned

Jul 29, 2021

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 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

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.

• Maverick Family Counseling LCSW PLLC

  • Clinical Social Worker
  • Woodstock, NY
  • NPI 1104160738

  Multi-Specialty, NY

  Medicare reassignment NPD

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

{
    "created_epoch": "1627516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627516800000",
    "number": "1497428015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 ZENA RD",
            "city": "WOODSTOCK",
            "state": "NY",
            "postal_code": "124982626",
            "telephone_number": "845-679-6865",
            "fax_number": "845-679-5485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 ZENA RD",
            "city": "WOODSTOCK",
            "state": "NY",
            "postal_code": "124982626",
            "telephone_number": "845-679-8650",
            "fax_number": "845-679-5485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASSIK",
        "first_name": "EMILY",
        "middle_name": "ANN",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-29",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": "NY",
            "license": "18111198-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Monique O'Neil, LMT
• One World Family Medicine PC
• Marcia Darrelee Panza, R.N.
• Bruce Shea Parker, MA, LCSW
• Brian Pasquariello, LMSW
• Claudia Gutman Patch, D.M.D
• Shivani Patel
• Heather Dawn Pecoraro, MHC-LP
• Diane Pennay
• Emma Nicole Maley Pile, LMSW

• All providers in Woodstock, NY
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2021; 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.