Marisa Bassett De la Garza, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

084302-1 Issued in NY

Practice address

217 Highbridge St Apt 9
Fayetteville, NY 13066-1967

Phone

(206) 375-4421

NPI assigned

Jan 2, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Psychological Healthcare, PLLC

  • Professional Counselor
  • Syracuse, NY
  • NPI 1922109578
  NPD

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471392000000",
    "number": "1699832576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 HIGHBRIDGE ST APT 9",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130661967",
            "telephone_number": "206-375-4421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 HIGHBRIDGE ST APT 9",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130661967",
            "telephone_number": "206-375-4421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA GARZA",
        "first_name": "MARISA",
        "middle_name": "BASSETT",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-02",
        "last_updated": "2016-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WA",
            "license": "RC00047900",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "084302-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deann Lynn Cummings, MD.
• CVS Albany LLC
• Rachel Marie Damon, RPA-C
• David a. Thorpe
• Rebecca Dayton, PH.D.
• Maryanne Delaney, RN
• Erika Delisle, PA-C
• Denis F Branson MD Professional Corporation
• Denise C. Wolken, MD PLLC
• Deanna Marie Derrenbacker, PT

• Clinical Social Worker in Fayetteville, NY
• Providers in Fayetteville, 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 Aug 17, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.