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KELISHA MARK
NPI 1912667692
Social Worker in New York, NY

Active since December 22, 2021PECOS EnrolledAccepts Medicare Assignment
77 WATER ST, NEW YORK, NY 10005(347) 440-5869 Get Directions Write a Review

NPPES record last updated: December 22, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kelisha Mark NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELISHA MARK (NPI 1912667692) is an individual social worker in New York, New York, licensed in New York (100364) and active in the NPI registry since December 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2008).

NPPES Registry Identity

NPI1912667692
Entity TypeIndividualFemale
Primary Taxonomy104100000X
Provider Legal NameKELISHA MARK
Location Address77 WATER STNew York, NY 10005-4401
Mailing Address77 Water StNew York, NY 10005-4401 · (347) 440-5869
Phone(347) 440-5869
Sole ProprietorNo
Medical School CMSOtherGraduated 2008
Enumeration DateDecember 22, 2021
NPPES CertifiedSeptember 4, 2021
✔ NPI 1912667692 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial WorkerBehavioral Health & Social Service Providers
Taxonomy Code104100000X
License✔ Licensed in NY · 100364
Definition
A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.
77 WATER ST, New York, NY 10005
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Other Names 1

Former Name (1)Kelisha Melbourne

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kelisha Mark is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6800384082
PECOS Enrollment IDI20251021000465
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NASIHA COUNSELING
Social Worker (Clinical)
77 WATER ST, STE 854
NEW YORK, NY 10005
New York County (646) 926-6675
KAYLEE ANN WOOD
Behavior Analyst
77 WATER ST
NEW YORK, NY 10005
New York County (718) 215-5311
AISHA MILLINER
Registered Nurse (Case Management)
77 WATER ST
NEW YORK, NY 10005
New York County (347) 714-4887

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelisha Mark's NPI number?

The NPI number for Kelisha Mark is 1912667692. It was assigned to this individual provider in the NPPES registry on December 22, 2021. The provider is also known as Kelisha Melbourne.

Where is Kelisha Mark located?

Kelisha Mark practices at 77 Water St, New York, NY 10005. The listed phone number is (347) 440-5869.

What is Kelisha Mark's specialty?

The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.

Is Kelisha Mark enrolled in Medicare?

Yes. Kelisha Mark is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Kelisha Mark was last updated on December 22, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.