Individual provider Active NPI

Marietta G Wert, LCSW

  • Clinical Social Worker
  • Wyomissing, PA
National Provider Identifier
1033216155
Registry record updated Dec 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW018812 Issued in PA
Practice address
716 N Park Rd
Wyomissing, PA 19610-2912
Phone
(610) 375-0544
Fax
(610) 378-9779
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X SW001639E PA
Clinical Social Worker 1041C0700X CW018812 PA Primary

Addresses

Primary practice location

716 N Park Rd
Wyomissing, PA 19610-2912

Mailing address

716 N Park Rd
Wyomissing, PA 19610-2912
Phone (610) 375-0544

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW001639EPAMDSocial Worker
CW018812PAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448928000000",
    "number": "1033216155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 N PARK RD",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196102912",
            "telephone_number": "610-375-0544",
            "fax_number": "610-378-9779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 N PARK RD",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196102912",
            "telephone_number": "610-375-0544",
            "fax_number": "610-378-9779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WERT",
        "first_name": "MARIETTA",
        "middle_name": "G",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2015-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW001639E",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW018812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyomissing, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2015; 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.