MARISA C MATSUDAIRA (NPI# 1871741314) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871741314 |
| Entity Type | Individual |
| Full Name | MARISA C MATSUDAIRA |
| Credential | MSW |
| Practice Address |
10 Graham Rd W Ithaca NY 14850-1055 |
| Practice Telephone | 6072572188 |
| Enumeration Date | 2008-09-08 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 104100000X | Social Worker | Behavioral Health & Social Service Providers | ||
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 127 W State St, Ithaca, NY 148505427 | 6072727494 |
| Street Address |
10 GRAHAM RD W |
| City | ITHACA |
| State | NY |
| Zip Code | 14850-1055 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619959582 | Jeffrey David Snedeker | Pediatrics | 10 Graham Rd W, Ithaca, NY 14850-1055 | 2005-11-16 |
| 1700431376 | Caitlin C Griffin | Nurse Practitioner | 10 Graham Rd W, Ithaca, NY 14850-1055 | 2019-08-09 |
| 1871061473 | Caroline Furman | Pediatrics | 10 Graham Rd W, Ithaca, NY 14850-1055 | 2018-11-13 |
| 1376084822 | Jessica Conner | Psychologist | 10 Graham Rd W, Ithaca, NY 14850-1055 | 2017-03-16 |
| 1326596917 | Bryan H Powell | Physician Assistant | 10 Graham Rd W, Ithaca, NY 14850-1055 | 2016-09-13 |
| 1639533664 | Brian Jeffrey Kramer | Pediatrics | 10 Graham Rd W, Ithaca, NY 14850-1055 | 2016-04-06 |
| 1528476629 | Katherine Rudert | Nurse Practitioner | 10 Graham Rd W, Ithaca, NY 14850-1055 | 2014-08-01 |
| 1548689920 | Brittany J Raffa | Pediatrics | 10 Graham Rd W, Ithaca, NY 14850-1055 | 2014-04-14 |
| 1558628255 | Lindsay Brianne Tamborelle | Pediatrics | 10 Graham Rd W, Ithaca, NY 14850-1055 | 2012-04-19 |
| 1548527344 | Nina E Pegram | Nurse Practitioner | 10 Graham Rd W, Ithaca, NY 14850-1055 | 2012-04-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174123897 | Michelle Lee Sanito | Registered Nurse | 400 Lake Street, Ithaca, NY 14850 | 2020-10-30 |
| 1457959843 | Summit Alternatives Lmsw PC | Community/Behavioral Health | 215 North Cayuga Street, 2nd Floor Business Complex, Ithaca, NY 14850 | 2020-10-16 |
| 1518581701 | Sameer Acharya | Student in an Organized Health Care Education/Training Program | Internal Medicine Residency, Cayuga Medical Center, 101 Dates Drive, Ithaca, NY 14850 | 2020-06-03 |
| 1699399873 | Anurag Aryal | Student in an Organized Health Care Education/Training Program | 101 Dates Drive Internal Medicine Residency, Cayuga Med, Ithaca, NY 14850 | 2020-06-03 |
| 1932723228 | Binay Kumar Kshetree | Student in an Organized Health Care Education/Training Program | Cayuga Medical Center, 101 Dates Drive, Ithaca, NY 14850 | 2020-06-02 |
| 1225657349 | Nima Hazrati Pour Fard | Student in an Organized Health Care Education/Training Program | Internal Medicine Residency Cayuga Medical Center, 101, Ithaca, NY 14850 | 2020-04-09 |
| 1326671090 | Garret Hoskey | Specialist/Technologist | 953 Dany Road, Ithaca, NY 14850 | 2020-02-20 |
| 1609407709 | En-ting Hsu | Marriage & Family Therapist | 110 N. Cayuga Street 4th Floor Suite 3, Ithaca, NY 14850 | 2020-01-28 |
| 1306491063 | Patrick Owen Mckeon | Specialist/Technologist | Hill Center G66, 953 South Danby Rd., Ithaca, NY 14850 | 2019-08-08 |
| 1538722343 | Priyesh Thakurathi | Student in an Organized Health Care Education/Training Program | 101 Dates Drive Cayuga Medical Center, Internal Medicine Residency Program, Ithaca, NY 14850 | 2019-04-17 |
| Find all providers in zip 14850 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013535681 | Thomas Andrew Schlee | Social Worker | 5350 Iradell Rd, Ithaca, NY 14850-9257 | 2020-07-10 |
| 1447871629 | Donna L George | Social Worker | 106 Troy Rd, Ithaca, NY 14850-9447 | 2020-04-29 |
| 1801368808 | Michelle Russo, Lcsw | Social Worker | 108 N Cayuga St, Ithaca, NY 14850-4346 | 2019-01-02 |
| 1285102236 | Rebecca Lee | Social Worker | 950 Danby Rd Ste 129, Ithaca, NY 14850-5731 | 2018-11-07 |
| 1841736584 | Marilynne Sommers, Private Practice | Social Worker | 617 N Cayuga St, Ithaca, NY 14850-3607 | 2017-01-18 |
| 1497113328 | J A Mcknight | Social Worker | 430 W State St, Ste 208, Ithaca, NY 14850-5279 | 2016-02-06 |
| 1750774329 | Ellen Maranca | Social Worker | 109 S Albany St, Suite 206, Ithaca, NY 14850-5434 | 2015-03-06 |
| 1700200995 | Cindy Lee Glanville | Social Worker | 108 S. Albany St., Ithaca, NY 14850 | 2014-02-10 |
| 1225451289 | Joanne Taormina | Social Worker | 9 Waterview Cir, Ithaca, NY 14850-9588 | 2014-01-28 |
| 1265863237 | Scott Steelman | Social Worker | 20 Esty Dr, Ithaca, NY 14850-9701 | 2013-12-02 |
| Find all providers in ITHACA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.