Marissa Hagerla

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

110 Jericho Tpke Ste 212
Floral Park, NY 11001-2019

Phone

(507) 339-7406

NPI assigned

Feb 17, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• David Lawrence Mental Health Center, Inc

  • Community/Behavioral Health Agency
  • Naples, FL
  • NPI 1801891940

  FL, Single Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1676592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676592000000",
    "number": "1891493045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6625 ILEX CIR APT C",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341096900",
            "telephone_number": "239-285-7517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 JERICHO TPKE STE 212",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "110012019",
            "telephone_number": "507-339-7406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGERLA",
        "first_name": "MARISSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-17",
        "last_updated": "2023-02-17",
        "certification_date": "2023-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHILADELPHIA INSURANCE COMPANIES",
            "identifier": "AR252628",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas Michael Guilfoyle, DDS
• Nimra Gul, PHARMD
• Raymond Gutierrez, PT
• Diane Haber
• Usman Habib
• Syed Haider, DO
• Dianne Carol Hanson, NP
• Relyn Harley
• Christine Hartnett, R.N.
• Joan Hartnett, ANP

• All providers in Floral Park, NY
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.