Individual provider Active NPI

Myra Marcus, PHD DSW MSW LCSW

  • Clinical Social Worker
  • Mamaroneck, NY
National Provider Identifier
1659352615
Registry record updated Feb 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW3305 Issued in FL
Practice address
585 N Barry Ave
Suite 2
Mamaroneck, NY 10543-1633
Phone
(914) 356-5110
NPI assigned
Nov 8, 2005
Last updated
Feb 26, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2013

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 SW3305 FL Primary

Addresses

Primary practice location

585 N Barry Ave
Suite 2
Mamaroneck, NY 10543-1633

Mailing address

7 East Avenue
#3S
Larchmont, NY 10538-1336
Phone (914) 356-5110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, CT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040901000141 FL Practitioner - Clinical Social Worker 5698740983 Reassigns benefits to 1 organization
Practice locations: Estero, FL
I20111227000731 CT Practitioner - Clinical Social Worker 5698740983 Practice locations: Cheshire, CT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fort Myers Psychology PAGroup PAC ID 6204936305, 9 clinicians

Practice addresses (Care Compare)

12791 World Plaza LN
BLDG 89
Fort Myers, FL 33907-3989
Phone (239) 829-5494

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
SW3305FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Fort Myers Psychology, PA CurrentSince Dec 22, 2021 Accepting new patients
Myra Marcus PA Clinical PastSince Jun 30, 2004 Accepting new patients

Locations

12791 World Plaza Ln
Bldg 89
Fort Myers, FL 33907
Phone (239) 247-1756

15950 McGregor Blvd
Fort Myers, FL 33908
Phone (239) 454-1277

Organizations & group practices 2

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": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361836800000",
    "number": "1659352615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 EAST AVENUE",
            "address_2": "#3S",
            "city": "LARCHMONT",
            "state": "NY",
            "postal_code": "105381336",
            "telephone_number": "914-356-5110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 N BARRY AVE",
            "address_2": "SUITE 2",
            "city": "MAMARONECK",
            "state": "NY",
            "postal_code": "105431633",
            "telephone_number": "914-356-5110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCUS",
        "first_name": "MYRA",
        "name_prefix": "Dr.",
        "credential": "PHD DSW MSW LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-08",
        "last_updated": "2013-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW3305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mamaroneck, NY

Sources for this page

Verify at the official NPI Registry.