Marcia H Hertzog, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R028240-1 Issued in NY

Practice address

361 W Water St
Elmira, NY 14905-2519

Phone

(607) 737-4063

Fax

(607) 734-2019

NPI assigned

Jul 10, 2007

Last updated

Aug 12, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialty

Clinical Social Worker

Education

Other, 1981

Medicare assignment

May accept Medicare assignment

Group practices

Southern Tier Counseling Center LLCGroup PAC ID 1658322805, 4 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Southern Tier Counseling Center, LLC

  • Clinical Social Worker
  • Elmira, NY
  • NPI 1598716292
  Medicare reassignment Care Compare group NPD
• Family Services of Chemung County, Inc.

  • Counselor
  • Elmira, NY
  • NPI 1619922432
  Medicare reassignment NPD

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470960000000",
    "number": "1508064551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "361 W.WATER ST",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149013332",
            "telephone_number": "607-737-4063",
            "fax_number": "607-734-2019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "361 W WATER ST",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149052519",
            "telephone_number": "607-737-4063",
            "fax_number": "607-734-2019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERTZOG",
        "first_name": "MARCIA",
        "middle_name": "H",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-10",
        "last_updated": "2016-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R028240-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald Lee Herman, RPH
• Gwinnette R Hernandez, NP
• Heather D Heroux, MSPT
• Susan Herron
• David Hersh, R.N
• Kenneth Herzl-Betz, M.D.
• Doreen Joyce Hettinger, LPN
• Paul Samuel Hicks, M.D.
• Tamara Higgins, CNM
• Julie Anne Hill

• Clinical Social Worker in Elmira, NY
• Providers in Elmira, 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 Aug 12, 2016; 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.