Individual provider Active NPI

Jessica Marmion, LCSW-R

  • Clinical Social Worker
  • Williamsville, NY
National Provider Identifier
1598029746
Registry record updated May 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
73 080076 Issued in NY
Practice address
2829 Wehrle Dr Ste 13
Williamsville, NY 14221-7387
Phone
(585) 301-2983
Fax
(716) 355-0840
NPI assigned
Jul 2, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2024

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 73 080076 NY Primary

Addresses

Primary practice location

2829 Wehrle Dr Ste 13
Williamsville, NY 14221-7387

Mailing address

2829 Wehrle Dr Ste 13
Williamsville, NY 14221-7387
Phone (585) 301-2983

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • 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
I20141125001774 NY Practitioner - Clinical Social Worker 8527380765 Practice locations: Williamsville, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
73 080076NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Wny Peaceful Warrior LLC Clinical Current Accepting new patients

Locations

6225 Sheridan Dr
Ste 110
Williamsville, NY 14221
Phone (716) 204-8419

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.

NPI Registry JSON

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

{
    "created_epoch": "1341187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717113600000",
    "number": "1598029746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2829 WEHRLE DR STE 13",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142217387",
            "telephone_number": "585-301-2983",
            "fax_number": "716-355-0840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2829 WEHRLE DR STE 13",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142217387",
            "telephone_number": "585-301-2983",
            "fax_number": "716-355-0840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARMION",
        "first_name": "JESSICA",
        "credential": "LCSW-R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-02",
        "last_updated": "2024-05-31",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "73 080076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.