Maryann Fazio Heimrath, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R058366-1 Issued in NY

Practice address

137 W 24TH St
Suite 300
New York, NY 10011-1901

Phone

(646) 336-9267

NPI assigned

Apr 3, 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Park Therapy LCSW, PLLC

  • Clinical Social Worker
  • New York, NY
  • NPI 1356163760
  NPD Authorized official

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

{
    "created_epoch": "1207180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207180800000",
    "number": "1982877502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 W 24TH ST",
            "address_2": "SUITE 300",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100111901",
            "telephone_number": "646-336-9267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 W 24TH ST",
            "address_2": "SUITE 300",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100111901",
            "telephone_number": "646-336-9267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAZIO HEIMRATH",
        "first_name": "MARYANN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-03",
        "last_updated": "2008-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": "NY",
            "license": "000487",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R058366-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shamy Bushra Fazal, DPM
• Shazma Fazal, BSCOT
• Cynthia Drew Fazekas Young, DMD
• Mahdiya Fazel
• Sahar Fazel, DDS
• Barbara Elaine Fazio McGrory, LCSW
• Amanda Fazio, MHC
• Hanna Fazio, LMSW
• Irina Kotovsky Fazio, O.D.
• Kim M Fazio, LPN

• Clinical Social Worker in New York, NY
• Providers in New York, 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 Apr 3, 2008; 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.