Active NPI
Debra Demartino, LCSW
- Clinical Social Worker
- Hicksville, NY
National Provider Identifier
1538389119
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 069433-1
- Practice address
- 117 Harding Ave
Hicksville, NY 11801-3121 - Phone
- (516) 932-7619
- NPI assigned
- Apr 26, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 069433-1 | NY | Primary |
Addresses
Primary practice location
117 Harding Ave
Hicksville, NY 11801-3121
Mailing address
117 Harding Ave
Hicksville, NY 11801-3121
Phone (516) 932-7619
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 069433-1 | NY | MD | Clinical Social Worker |
| 060803 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Youth Environmental Services, Inc. | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba YES Community Counseling Center
- Public Health or Welfare Agency
- Massapequa, NY
- NPI 1215033139
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1538389119",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "117 HARDING AVE",
"city": "HICKSVILLE",
"state": "NY",
"postal_code": "118013121",
"telephone_number": "516-932-7619"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "117 HARDING AVE",
"city": "HICKSVILLE",
"state": "NY",
"postal_code": "118013121",
"telephone_number": "516-932-7619"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEMARTINO",
"first_name": "DEBRA",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "069433-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hicksville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.