Individual provider Active NPI

Mark Francis O'Brien, LCSW-R

  • Clinical Social Worker
  • Albion, NY
National Provider Identifier
1598072357
Registry record updated Aug 31, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R030428-1 Issued in NY
Practice address
14014 Route 31
Albion, NY 14411-9301
Phone
(585) 589-3260
Fax
(585) 589-6395
NPI assigned
Aug 31, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2010

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 R030428-1 NY Primary

Addresses

Primary practice location

14014 Route 31
Albion, NY 14411-9301

Mailing address

14014 Route 31
Albion, NY 14411-9301
Phone (585) 589-3260

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
I20110711000351 NY Practitioner - Clinical Social Worker 1951589225 Practice locations: Tonawanda, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
State University of New York at Buffalo School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

884 Brighton Rd
Tonawanda, NY 14150-8169
Phone (716) 536-9460

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R030428-1NYMDClinical Social Worker
030428NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1283212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283212800000",
    "number": "1598072357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14014 ROUTE 31",
            "city": "ALBION",
            "state": "NY",
            "postal_code": "144119301",
            "telephone_number": "585-589-3260",
            "fax_number": "585-589-6395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14014 ROUTE 31",
            "city": "ALBION",
            "state": "NY",
            "postal_code": "144119301",
            "telephone_number": "585-589-3260",
            "fax_number": "585-589-6395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "MARK",
        "middle_name": "FRANCIS",
        "name_prefix": "Mr.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-31",
        "last_updated": "2010-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R030428-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albion, NY

Sources for this page

Verify at the official NPI Registry.