Individual provider Active NPI

Willie Mae Murphy

  • Clinical Social Worker
  • Pearl River, NY
National Provider Identifier
1508212135
Registry record updated Nov 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
088755 Issued in NY
Practice address
2 Franklin Ave
Pearl River, NY 10965-2401
Phone
(917) 584-3063
NPI assigned
May 12, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X NJ
Clinical Social Worker 1041C0700X 088755 NY Primary

Addresses

Primary practice location

2 Franklin Ave
Pearl River, NY 10965-2401

Mailing address

168 Martin PL
Pearl River, NY 10965-2519
Phone (917) 584-3063

Other practice location 1

168 Martin PL
Pearl River, NY 10965-2519
Phone (917) 584-3063

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: No
  • 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
I20190718001356 NJ Practitioner - Clinical Social Worker 5496080038 Practice locations: Montvale, NJ

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
088755NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1463011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574380800000",
    "number": "1508212135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "168 MARTIN PL",
            "city": "PEARL RIVER",
            "state": "NY",
            "postal_code": "109652519",
            "telephone_number": "917-584-3063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 FRANKLIN AVE",
            "city": "PEARL RIVER",
            "state": "NY",
            "postal_code": "109652401",
            "telephone_number": "917-584-3063"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "168 MARTIN PL",
            "address_purpose": "LOCATION",
            "city": "PEARL RIVER",
            "state": "NY",
            "postal_code": "109652519",
            "country_code": "US",
            "telephone_number": "917-584-3063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MURPHY",
        "first_name": "WILLIE MAE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-12",
        "last_updated": "2019-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "088755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearl River, NY

Sources for this page

Verify at the official NPI Registry.