Monica Massaro, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

071289 Issued in NY

Practice address

1401 Main St
Port Jefferson, NY 11777-2225

Phone

(631) 928-0202

NPI assigned

Feb 4, 2020

Last updated

Feb 26, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• The Way Back, Inc.

  • Community/Behavioral Health Agency
  • Port Jefferson, NY
  • NPI 1205034857
  NPD (past)

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

{
    "created_epoch": "1580774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582675200000",
    "number": "1598396970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 MAIN ST",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772225",
            "telephone_number": "631-928-0202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 MAIN ST",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772225",
            "telephone_number": "631-928-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSARO",
        "first_name": "MONICA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-04",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "071289",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "071289",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maryhaven Center of Hope Inc.
• Maryhaven Center of Hope Inc.
• Maryhaven Center of Hope Inc.
• Samantha Marzano, LCSW
• Bisma Masroor
• Fiore Mastroianni, MD
• Salim A Matar, MD
• Diana Matari, PA-C
• Mather Faculty Medical Affiliates, University Faculty Practice Corpora
• Mather Primary Care, PLLC

• Clinical Social Worker in Port Jefferson, NY
• Providers in Port Jefferson, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2020; 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.