Marcela Blair, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

086596 Issued in NY

Practice address

369 Renwood Court
Lake Ariel, PA 18436

Phone

(718) 913-0234

NPI assigned

Apr 16, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA, NY2 enrollments

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 2

Specialty

Clinical Social Worker

Education

Other, 2018

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Built for Growth LLC

  • Clinical Social Worker
  • Port Jervis, NY
  • NPI 1790495364
  NPD Authorized official

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

{
    "created_epoch": "1208304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545782400000",
    "number": "1962676494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "348 THE HIDEOUT",
            "city": "LAKE ARIEL",
            "state": "PA",
            "postal_code": "184369772",
            "telephone_number": "171-891-3023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "369 RENWOOD COURT",
            "city": "LAKE ARIEL",
            "state": "PA",
            "postal_code": "18436",
            "telephone_number": "718-913-0234"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "84 Front St Ste 1A",
            "address_purpose": "LOCATION",
            "city": "Port Jervis",
            "state": "NY",
            "postal_code": "127712415",
            "country_code": "US",
            "telephone_number": "718-913-0234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLAIR",
        "first_name": "MARCELA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-16",
        "last_updated": "2018-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW020152",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "086596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Avenues Recovery Center of Lake Ariel, LLC
• Alexander R. Badiu
• Jennifer A Barillo, OT
• Brian A. Barland, RPH
• Heather Bergensten
• Jessica Rae Bodzio, MS,RDN,LDN
• Derek Jay Bowers, M.D.
• Sabrina Brennan
• Joseph John Brogenski Jr., RPH
• Amanda Burnside, MA, ATR-BC, LPC

• Clinical Social Worker in Lake Ariel, PA
• Providers in Lake Ariel, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.