Active NPI
Marla J Larock, LCSW
- Social Worker
- Wauwatosa, WI
National Provider Identifier
1508881863
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 7258-123
- Practice address
- 1220 Dewey Ave
Wauwatosa, WI 53213-2504 - Phone
- (414) 454-6600
- NPI assigned
- Jul 13, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 7258-123 | WI | Primary |
Addresses
Primary practice location
1220 Dewey Ave
Wauwatosa, WI 53213-2504
Mailing address
2246 N 65TH St
Wauwatosa, WI 53213-2034
Phone (414) 774-8516
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 43592500 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2600 N Mayfair Rd
Suite 650
Wauwatosa, WI 53226-1321
Phone (414) 771-9304
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shore Counseling and Consulting Clinic, S.C. | Current | Accepting new patients |
Locations
2600 N Mayfair Rd
Ste 650
Wauwatosa, WI 53226
Phone (414) 771-9304
Organizations & group practices 1
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.
-
- Group Psychotherapy Psychologist
- Milwaukee, WI
- NPI 1588710073
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673395200000",
"number": "1508881863",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2246 N 65TH ST",
"city": "WAUWATOSA",
"state": "WI",
"postal_code": "532132034",
"telephone_number": "414-774-8516"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1220 DEWEY AVE",
"city": "WAUWATOSA",
"state": "WI",
"postal_code": "532132504",
"telephone_number": "414-454-6600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAROCK",
"first_name": "MARLA",
"middle_name": "J",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-13",
"last_updated": "2023-01-11",
"certification_date": "2023-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "WI",
"license": "7258-123",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "43592500",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wauwatosa, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 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.