Mario H Irigoyen LCSW - LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

44SC05377600 Issued in NJ

Legal business name

MARIO H IRIGOYEN LCSW - LLC

Practice address

61 Grand Ave
Englewood, NJ 07631-3572

Phone

(914) 671-3924

Fax

(845) 942-1894

NPI assigned

Sep 6, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Mario H Irigoyen, LCSWNPI 1952607608

Title

Sole MBR

Phone

(914) 671-3924

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mario Hipolito Irigoyen, LCSW

  • Clinical Social Worker
  • Englewood, NJ
  • NPI 1952607608
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1315267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315267200000",
    "number": "1831470723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 THIELLS RD",
            "city": "STONY POINT",
            "state": "NY",
            "postal_code": "109803420",
            "telephone_number": "914-671-3924",
            "fax_number": "845-942-1894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 GRAND AVE",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076313572",
            "telephone_number": "914-671-3924",
            "fax_number": "845-942-1894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIO H IRIGOYEN LCSW - LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-06",
        "last_updated": "2011-09-06",
        "status": "A",
        "authorized_official_last_name": "IRIGOYEN",
        "authorized_official_first_name": "MARIO",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "SOLE MBR",
        "authorized_official_telephone_number": "914-671-3924",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NJ",
            "license": "44SC05377600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Marcus
• Sheera R Margolies, LCSW
• Dylan Adam Mariano, DPM
• Ryan James Mariano
• Marcelo Marin, DNP
• Yaffa Markovich, OTR/L
• Jacob E. Markovitz, MD
• Silvia Marques Costeira, MS LMFT LPC
• Marsh Ophthalmic Associates
• Martin Schub MD PA

• Community/Behavioral Health Agency in Englewood, NJ
• Providers in Englewood, NJ by specialty
• Community/Behavioral Health Agency in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2011; 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.