Individual provider Active NPI

Laura L Marr, LCSW

  • Clinical Social Worker
  • Fort Salonga, NY
National Provider Identifier
1659647626
Registry record updated Mar 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
079389-1 Issued in NY
Practice address
103 Fort Salonga Rd Ste 16
Fort Salonga, NY 11768-1454
Phone
(631) 261-5200
NPI assigned
Mar 23, 2012
Last updated
Mar 3, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 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 079389-1 NY Primary

Addresses

Primary practice location

103 Fort Salonga Rd Ste 16
Fort Salonga, NY 11768-1454

Mailing address

42 Senne Rd
Northport, NY 11768-1417
Phone (631) 261-5200

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
I20130807000527 NY Practitioner - Clinical Social Worker 8022250836 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

42 Senne Rd
Northport, NY 11768-1417
Phone (631) 561-9053

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
079389-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Laura Marr LCSW Services, P.C. Clinical CurrentSince Mar 28, 2013 Accepting new patients

Locations

103 Fort Salonga Rd
Ste 16
Northport, NY 11768
Phone (631) 261-5200

Organizations & group practices 1

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": "1332460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362268800000",
    "number": "1659647626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 SENNE RD",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "117681417",
            "telephone_number": "631-261-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 FORT SALONGA RD STE 16",
            "city": "FORT SALONGA",
            "state": "NY",
            "postal_code": "117681454",
            "telephone_number": "631-261-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARR",
        "first_name": "LAURA",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-23",
        "last_updated": "2013-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "079389-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Salonga, NY

Sources for this page

Verify at the official NPI Registry.