Individual provider Active NPI

Marisa Mohrer, LCSW, MPH

  • Clinical Social Worker
  • Guilford, CT
National Provider Identifier
1902423973
Registry record updated Jun 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC22413 Issued in ME
Practice address
5 Durham Rd Ste B5
Guilford, CT 06437-2076
Phone
(203) 752-7397
NPI assigned
Jun 25, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 125891 MA
Clinical Social Worker 1041C0700X LC22413 ME Primary

Addresses

Primary practice location

5 Durham Rd Ste B5
Guilford, CT 06437-2076

Mailing address

119 Dolan Dr
Guilford, CT 06437-2350
Phone (203) 752-7397

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
125891MAMDClinical Social Worker
LC22413MEMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1593043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1902423973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 DOLAN DR",
            "city": "GUILFORD",
            "state": "CT",
            "postal_code": "064372350",
            "telephone_number": "203-752-7397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 DURHAM RD STE B5",
            "city": "GUILFORD",
            "state": "CT",
            "postal_code": "064372076",
            "telephone_number": "203-752-7397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHRER",
        "first_name": "MARISA",
        "credential": "LCSW, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-25",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "125891",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC22413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guilford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.