Individual provider Active NPI

Marvin Soileau

  • Clinical Social Worker
  • Bohemia, NY
National Provider Identifier
1629796842
Registry record updated Nov 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
606 Johnson Ave Ste 9
Bohemia, NY 11716-2687
Phone
(646) 722-3300
NPI assigned
Aug 15, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2025

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 Primary

Addresses

Primary practice location

606 Johnson Ave Ste 9
Bohemia, NY 11716-2687

Mailing address

2248 Broadway # 1604
New York, NY 10024-5805

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

NPI Registry JSON

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

{
    "created_epoch": "1660521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762560000000",
    "number": "1629796842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2248 BROADWAY # 1604",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100245805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 JOHNSON AVE STE 9",
            "city": "BOHEMIA",
            "state": "NY",
            "postal_code": "117162687",
            "telephone_number": "646-722-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOILEAU",
        "first_name": "MARVIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-15",
        "last_updated": "2025-11-08",
        "certification_date": "2025-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bohemia, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2025; 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.