Marylynn R. Wiseman, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC04507100 Issued in NJ

Practice address

169 Dayton St
Ridgewood, NJ 07450-4407

Phone

(201) 445-3307

NPI assigned

Apr 4, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Oct 1, 2023 through Oct 1, 2027

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Pathways for Enhanced Living, LLC

  • Clinical Social Worker
  • Ridgewood, NJ
  • NPI 1154443588
  NPD (past) Authorized official

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342396800000",
    "number": "1942322433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 DAYTON ST",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074504407",
            "telephone_number": "201-445-3307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 DAYTON ST",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074504407",
            "telephone_number": "201-445-3307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISEMAN",
        "first_name": "MARYLYNN",
        "middle_name": "R.",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2012-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC04507100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William P Carney MD LLC
• Williambecker MD and Nina Sugar MD Child and Adolescentpsychiatry,LLC
• Willow Integrative Wellness
• Robert Spencer Wilson, LCSW
• Lydia Winnicka, M.D.
• Erik Wohlfarth
• Sharon McGovern Wolbert, PH.D.
• Murray A Wolkstein, MD
• Albert R Wolyniec, D.C.
• Womens Diagnostic Imaging, LLC

• Clinical Social Worker in Ridgewood, NJ
• Providers in Ridgewood, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2012; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.