Individual provider Active NPI

Marissa Falkoff

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1548858293
Registry record updated Jul 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
085851 Issued in NY
Practice address
1115 Broadway Ste 1117
New York, NY 10010-3450
Phone
(917) 791-0131
NPI assigned
Jan 7, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 085851 NY Primary

Addresses

Primary practice location

1115 Broadway Ste 1117
New York, NY 10010-3450

Mailing address

1380 Riverside Dr Apt 7C
New York, NY 10033-1026
Phone (917) 791-0131

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

LicenseStateTypeSpecialty
085851NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1609977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1548858293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 RIVERSIDE DR APT 7C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100331026",
            "telephone_number": "917-791-0131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 BROADWAY STE 1117",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100103450",
            "telephone_number": "917-791-0131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALKOFF",
        "first_name": "MARISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-07",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "085851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.