Individual provider Active NPI

Martha Mae Mashburn, LCSW

  • Clinical Social Worker
  • Hyde Park, NY
National Provider Identifier
1821214586
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R038800-1 Issued in NY
Practice address
4232 Albany Post Rd
Hyde Park, NY 12538-1766
Phone
(914) 456-6734
NPI assigned
Apr 18, 2007
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 R038800-1 NY Primary

Addresses

Primary practice location

4232 Albany Post Rd
Hyde Park, NY 12538-1766

Mailing address

21 Franklin Rd
Hyde Park, NY 12538-2333
Phone (845) 229-5370

Other identifiers 4

IdentifierTypeStateIssuer
N464HOtherNYMAGELLAN
7334046004OtherNYVALUE OPTIONS
P2797605OtherNYOXFORD
115657OtherNYUNITED BEHAVIORAL HEALTH

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
R038800-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821214586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 FRANKLIN RD",
            "city": "HYDE PARK",
            "state": "NY",
            "postal_code": "125382333",
            "telephone_number": "845-229-5370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4232 ALBANY POST RD",
            "city": "HYDE PARK",
            "state": "NY",
            "postal_code": "125381766",
            "telephone_number": "914-456-6734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASHBURN",
        "first_name": "MARTHA",
        "middle_name": "MAE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R038800-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "N464H",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "7334046004",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2797605",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED BEHAVIORAL HEALTH",
            "identifier": "115657",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.