Individual provider Active NPI

Jennifer A Marzzacco, LSW

  • Social Worker
  • Moosic, PA
National Provider Identifier
1982030359
Registry record updated Apr 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
SW130825 Issued in PA
Practice address
4101 Birney Ave
Moosic, PA 18507-1323
Phone
(570) 961-3361
Fax
(570) 961-3364
NPI assigned
Sep 17, 2013
Last updated
Apr 16, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X SW130825 PA Primary

Addresses

Primary practice location

4101 Birney Ave
Moosic, PA 18507-1323

Mailing address

4101 Birney Ave
Moosic, PA 18507-1323
Phone (570) 961-3361

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20191112000461 PA Practitioner - Clinical Social Worker 4688006703 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
John G Kuna Psy D and Associates LLCGroup PAC ID 5890950281, 24 clinicians

Practice addresses (Care Compare)

4101 Birney Ave
Moosic, PA 18507-1323
Phone (570) 961-3361

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW130825PAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
John G Kuna Psy D & Associates LLC CurrentSince Oct 1, 2019 Accepting new patients

Locations

1011 Pennsylvania Ave
Matamoras, PA 18336
Phone (570) 491-4728

4101 Birney Ave
Moosic, PA 18507
Phone (507) 961-3361

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1379376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429142400000",
    "number": "1982030359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 BIRNEY AVE",
            "city": "MOOSIC",
            "state": "PA",
            "postal_code": "185071323",
            "telephone_number": "570-961-3361",
            "fax_number": "570-961-3364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 BIRNEY AVE",
            "city": "MOOSIC",
            "state": "PA",
            "postal_code": "185071323",
            "telephone_number": "570-961-3361",
            "fax_number": "570-961-3364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARZZACCO",
        "first_name": "JENNIFER",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-17",
        "last_updated": "2015-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW130825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moosic, PA

Sources for this page

Verify at the official NPI Registry.