Marissa Desiderio, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

083456 Issued in NY

Practice address

4955 N Bailey Ave Ste 108
Amherst, NY 14226-1206

Phone

(716) 427-2071

Fax

(716) 303-7002

NPI assigned

Apr 29, 2017

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1493424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671148800000",
    "number": "1972038776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 PARKDALE AVE UPPR",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142131428",
            "telephone_number": "716-316-3455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4955 N BAILEY AVE STE 108",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142261206",
            "telephone_number": "716-427-2071",
            "fax_number": "716-303-7002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESIDERIO",
        "first_name": "MARISSA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-29",
        "last_updated": "2022-12-16",
        "certification_date": "2022-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "083456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dent Neurologic
• Dent Neurologic Group LLP
• Dent Neurologic Group, LLP
• Dent Neurologic Group, LLP
• Dent Neurologic Group, LLP
• Melissa Jane Desouza, RPA-C
• Ellen Denise Devere, M.D.
• Tania I. Didas, PA-C
• Kathryn Diekmann
• Jenna Elyse Diliberta, PA-C

• Clinical Social Worker in Amherst, NY
• Providers in Amherst, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2022; 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.