Organization Active NPI

Laura Marr LCSW Services, P.C.

  • Clinical Social Worker
  • Fort Salonga, NY
National Provider Identifier
1811237100
Registry record updated Sep 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
739389 Issued in NY
Legal business name
LAURA MARR LCSW SERVICES, P.C.
Practice address
103 Fort Salonga Rd Ste 16
Fort Salonga, NY 11768-1454
Phone
(631) 261-5200
Fax
(631) 561-6220
NPI assigned
Feb 22, 2013
Last updated
Sep 18, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2013

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

Authorized official

Name
Ms. Laura L Marr, LCSWNPI 1659647626
Title
Owner/President
Phone
(631) 261-5200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 739389 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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130807000428 NY Part B Supplier - Clinic/Group Practice 5698917490 Receives reassigned benefits from 1 practitioner
Practice locations: Northport, NY

National Provider Directory

National Provider Directory

Locations

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1361491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379462400000",
    "number": "1811237100",
    "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",
            "fax_number": "631-561-6220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAURA MARR LCSW SERVICES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-22",
        "last_updated": "2013-09-18",
        "status": "A",
        "authorized_official_last_name": "MARR",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "631-261-5200",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "739389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Salonga, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.