Individual provider Active NPI

Ellen Sandra Marshall

  • Clinical Social Worker
  • New Paltz, NY
National Provider Identifier
1932340569
Registry record updated Mar 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
RO39583-1 Issued in NY
Practice address
66 Dubois Rd
New Paltz, NY 12561-3820
Phone
(845) 255-2379
NPI assigned
Mar 11, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2009

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 RO39583-1 NY Primary

Addresses

Primary practice location

66 Dubois Rd
New Paltz, NY 12561-3820

Mailing address

66 Dubois Rd
New Paltz, NY 12561-3820
Phone (845) 255-2379

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20231115003034 NY Practitioner - Clinical Social Worker 5799132536 Practice locations: New Paltz, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

66 Dubois Rd
New Paltz, NY 12561-3820
Phone (845) 430-5579

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RO39583-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1236729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236729600000",
    "number": "1932340569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 DUBOIS RD",
            "city": "NEW PALTZ",
            "state": "NY",
            "postal_code": "125613820",
            "telephone_number": "845-255-2379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 DUBOIS RD",
            "city": "NEW PALTZ",
            "state": "NY",
            "postal_code": "125613820",
            "telephone_number": "845-255-2379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "ELLEN",
        "middle_name": "SANDRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-11",
        "last_updated": "2009-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "RO39583-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Paltz, NY

Sources for this page

Verify at the official NPI Registry.