Crewson Andrew Martin, M.S.W., L-C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R038729-1 Issued in NY

Practice address

210 Liberty Ave
Port Jefferson, NY 11777-2010

Phone

(631) 880-2531

Fax

(631) 476-1835

NPI assigned

May 31, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• William Richard Lauterbach Former name

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

Specialty

Clinical Social Worker

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668556800000",
    "number": "1659318848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 LIBERTY AVE",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772010",
            "telephone_number": "631-880-2531",
            "fax_number": "631-476-1835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 LIBERTY AVE",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772010",
            "telephone_number": "631-880-2531",
            "fax_number": "631-476-1835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "CREWSON",
        "middle_name": "ANDREW",
        "credential": "M.S.W., L-C.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "R038729-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R038729-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WILLIAM",
            "last_name": "LAUTERBACH",
            "middle_name": "RICHARD",
            "credential": "M.S.W., L-C.S.W.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ronni Marangoni
• Markella Christakis MD PC
• Maury A Marmor, M.D.
• William Marrin, PHD
• Jennifer Dale Marshak, MD
• Dawn Ann Martin
• Janice M Martin, LCSW
• Paige Martinez
• Joseph Carmine Martino, DMD
• Melissa Jilll Marvin-Melzer, PT

• 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 Nov 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.