Active NPI
Bruce R Mardiney, LCSW
- School Social Worker
- New Paltz, NY
National Provider Identifier
1942579800
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Social Worker
- License
- 069967-1
- Practice address
- 175 Route 32 North
New Paltz, NY 12561 - Phone
- (845) 255-1400
- NPI assigned
- Dec 22, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Social Worker | 1041S0200X | 069967-1 | NY | Primary |
Addresses
Primary practice location
175 Route 32 North
New Paltz, NY 12561
Mailing address
175 Mountain Rd
Rosendale, NY 12472-9652
Phone (845) 658-3467
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
| License | State | Type | Specialty |
|---|---|---|---|
| 069967-1 | NY | MD | School Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1324512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1324512000000",
"number": "1942579800",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "175 MOUNTAIN RD",
"city": "ROSENDALE",
"state": "NY",
"postal_code": "124729652",
"telephone_number": "845-658-3467"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "175 ROUTE 32 NORTH",
"city": "NEW PALTZ",
"state": "NY",
"postal_code": "12561",
"telephone_number": "845-255-1400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARDINEY",
"first_name": "BRUCE",
"middle_name": "R",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-12-22",
"last_updated": "2011-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041S0200X",
"taxonomy_group": "",
"desc": "Social Worker, School",
"state": "NY",
"license": "069967-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Paltz, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.