Marian Susan Sanborn LCSW PLLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

MARIAN SUSAN SANBORN LCSW PLLC

Practice address

136 Jersey Ave
Port Jervis, NY 12771-2611

Phone

(845) 328-0133

NPI assigned

Aug 7, 2023

Organization subpart

No

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

Authorized official

Name

Nicole Saborn

Title

Insurance Coordinator

Phone

(570) 994-6920

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Marian Sanborn, LCSW

  • Clinical Social Worker
  • Monroe, NY
  • NPI 1609384429
  Medicare reassignment NPD

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

{
    "created_epoch": "1691366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703203200000",
    "number": "1508548744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 AVENUE M",
            "city": "MATAMORAS",
            "state": "PA",
            "postal_code": "183361811",
            "telephone_number": "845-328-0133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 JERSEY AVE",
            "city": "PORT JERVIS",
            "state": "NY",
            "postal_code": "127712611",
            "telephone_number": "845-328-0133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIAN SUSAN SANBORN LCSW PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-07",
        "last_updated": "2023-12-22",
        "certification_date": "2023-12-22",
        "status": "A",
        "authorized_official_last_name": "SABORN",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "INSURANCE COORDINATOR",
        "authorized_official_telephone_number": "570-994-6920"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emmanise Louis I, FNP
• Jessica Lyko
• Dipti U Maniar, DDS
• Nicole Manzare
• Kenneth Manzo, R.PH.
• Zaharoula Maris, D.M.D.
• Kellie A Markle
• Cynthia Marsilio, A.N.P.
• Barbara Marie Marszalek, FPMHNP
• Emmanuel M Martakis, MD

• Mental Health Clinic/Center (Including Community Mental Health Center) in Port Jervis, NY
• Providers in Port Jervis, NY by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.