Individual provider Active NPI

Marshall William Archer Debruhl, LMSW

  • Social Worker
  • Warwick, NY
National Provider Identifier
1770945297
Registry record updated Mar 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
72 092869 Issued in NY
Practice address
56 Little York Rd
Warwick, NY 10990-2231
Phone
(845) 545-4618
NPI assigned
Mar 23, 2016
Last updated
Mar 23, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 72 092869 NY Primary

Addresses

Primary practice location

56 Little York Rd
Warwick, NY 10990-2231

Mailing address

56 Little York Rd
Warwick, NY 10990-2231
Phone (845) 545-4618

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
72 092869NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1458691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458691200000",
    "number": "1770945297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 LITTLE YORK RD",
            "city": "WARWICK",
            "state": "NY",
            "postal_code": "109902231",
            "telephone_number": "845-545-4618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 LITTLE YORK RD",
            "city": "WARWICK",
            "state": "NY",
            "postal_code": "109902231",
            "telephone_number": "845-545-4618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBRUHL",
        "first_name": "MARSHALL",
        "middle_name": "WILLIAM ARCHER",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-23",
        "last_updated": "2016-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "72 092869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, NY

Sources for this page

Verify at the official NPI Registry.