Individual provider Active NPI

Lynn Marlene Marcus, LICSW

  • Clinical Social Worker
  • Haydenville, MA
National Provider Identifier
1871658328
Registry record updated Nov 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
110716 Issued in MA
Practice address
132 Main St Route 9
3Rd Floor Brassworks Building
Haydenville, MA 01039
Phone
(413) 883-6329
NPI assigned
Dec 26, 2006
Last updated
Nov 1, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2012

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 110716 MA Primary

Addresses

Primary practice location

132 Main St Route 9
3Rd Floor Brassworks Building
Haydenville, MA 01039

Mailing address

1236 Main St
Suite 201
Holyoke, MA 01040-2955
Phone (413) 533-4546

Other identifiers 3

IdentifierTypeStateIssuer
P08224OtherMABLUE CROSS BLUE SHIELD
595770000OtherMAMAGELLAN
32624OtherMAHEALTH NEW ENGLAND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, CT2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20031117000016 MA Practitioner - Clinical Social Worker 7012821952 Practice locations: Northampton, MA
I20071117000111 CT Practitioner - Clinical Social Worker 7012821952 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

241 King St
Suite 218
Northampton, MA 01060-2341
Phone (413) 533-4546

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
110716MAMDClinical Social Worker
6566CTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Jewish Family Services of Greater Hartford Clinical CurrentSince Oct 8, 2007 Accepting new patients
Western Mass Physician Associates Inc Past Accepting new patients

Locations

333 Bloomfield Ave
Ste A
West Hartford, CT 06117
Phone (860) 236-1927

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351728000000",
    "number": "1871658328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1236 MAIN ST",
            "address_2": "SUITE 201",
            "city": "HOLYOKE",
            "state": "MA",
            "postal_code": "010402955",
            "telephone_number": "413-533-4546",
            "fax_number": "413-322-8345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 MAIN ST ROUTE 9",
            "address_2": "3RD FLOOR BRASSWORKS BUILDING",
            "city": "HAYDENVILLE",
            "state": "MA",
            "postal_code": "01039",
            "telephone_number": "413-883-6329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCUS",
        "first_name": "LYNN",
        "middle_name": "MARLENE",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-26",
        "last_updated": "2012-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "110716",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "P08224",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "595770000",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NEW ENGLAND",
            "identifier": "32624",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Haydenville, MA

Sources for this page

Verify at the official NPI Registry.