Marney Wayne Defoore, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

37462 Issued in TX

Practice address

4203 Woodcock Drive
Suite 202
San Antonio, TX 78228-1312

Phone

(210) 883-7877

Fax

(888) 366-6472

NPI assigned

Jan 15, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1231977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476316800000",
    "number": "1669619409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4203 WOODCOCK DR",
            "address_2": "SUITE 202",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782281312",
            "telephone_number": "210-883-7877",
            "fax_number": "888-366-6472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4203 WOODCOCK DRIVE",
            "address_2": "SUITE 202",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782281312",
            "telephone_number": "210-883-7877",
            "fax_number": "888-366-6472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFOORE",
        "first_name": "MARNEY",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-15",
        "last_updated": "2016-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "37462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawna Mohney Deeves, M.D.
• Erica Grace Defee
• Mary Ellen Deffenbaugh, OTR
• Definitive Residential Care, LLC
• Cheryl Ann Defontaine, PNP
• Patricia Kelley Deforest, DO
• David Kyle Defrees
• Meredith R Defrees
• Ralph A Defronzo, MD
• Michael Degaetano, DO

• Clinical Social Worker in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2016; 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.