Individual provider Active NPI

Mariola Ferenc, LCSW

  • Clinical Social Worker
  • Gilbert, AZ
National Provider Identifier
1083259857
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-22776 Issued in AZ
Practice address
1760 E Pecos Rd Ste 344
Gilbert, AZ 85295-3208
Phone
(480) 613-3817
NPI assigned
Nov 15, 2019
Last updated
Mar 31, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 149.024796 IL
Social Worker 104100000X
Clinical Social Worker 1041C0700X LCSW-22776 AZ Primary

Addresses

Primary practice location

1760 E Pecos Rd Ste 344
Gilbert, AZ 85295-3208

Mailing address

414 Plaza Dr Ste 301
Westmont, IL 60559-5508
Phone (708) 745-6555

Other practice location 1

414 Plaza Dr Ste 301
Westmont, IL 60559-5508
Phone (708) 745-6555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20221018000928 IL Practitioner - Clinical Social Worker 0345616223 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.024796ILMDProfessional Counselor
LCSW-22776AZMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grace Integrated, LLC Professional CurrentSince Sep 6, 2022 Accepting new patients

Locations

125 Windsor Dr
Ste 113
Oak Brook, IL 60523
Phone (630) 728-1744

414 Plaza Dr
Ste 301
Westmont, IL 60559
Phone (630) 728-1744

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": "1573776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1083259857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 PLAZA DR STE 301",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605595508",
            "telephone_number": "708-745-6555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 E PECOS RD STE 344",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852953208",
            "telephone_number": "480-613-3817"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "414 Plaza Dr Ste 301",
            "address_purpose": "LOCATION",
            "city": "Westmont",
            "state": "IL",
            "postal_code": "605595508",
            "country_code": "US",
            "telephone_number": "708-745-6555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERENC",
        "first_name": "MARIOLA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-15",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "149.024796",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-22776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.