Individual provider Active NPI

Marcia Jo Dareff-Wenn, LCSW

  • Clinical Social Worker
  • Lake Placid, NY
National Provider Identifier
1700952652
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
063661-1 Issued in NY
Practice address
18 Coyote Way
Lake Placid, NY 12946
Phone
(512) 523-7840
NPI assigned
Nov 24, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 063661-1 NY Primary

Addresses

Primary practice location

18 Coyote Way
Lake Placid, NY 12946

Mailing address

18 Coyote Way
Lake Placid, NY 12946
Phone (518) 523-7840

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
063661-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700952652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 COYOTE WAY",
            "city": "LAKE PLACID",
            "state": "NY",
            "postal_code": "12946",
            "telephone_number": "518-523-7840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 COYOTE WAY",
            "city": "LAKE PLACID",
            "state": "NY",
            "postal_code": "12946",
            "telephone_number": "512-523-7840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAREFF-WENN",
        "first_name": "MARCIA",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "063661-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Placid, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.