Individual provider Active NPI

Mary Mauricella Hogan, LCSW

  • Clinical Social Worker
  • Miami, OK
National Provider Identifier
1124093984
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1125 Issued in OK
Practice address
200 2ND Ave SW
Miami, OK 74354-6830
Phone
(918) 540-7433
Fax
(918) 540-7474
NPI assigned
Feb 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1125 OK Primary

Addresses

Primary practice location

200 2ND Ave SW
Miami, OK 74354-6830

Mailing address

200 2ND Ave SW
Miami, OK 74354-6830
Phone (918) 540-7433

Other names 1

  • Mary Mauricella Lauchner Former name

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
1125OKMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124093984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 2ND AVE SW",
            "city": "MIAMI",
            "state": "OK",
            "postal_code": "743546830",
            "telephone_number": "918-540-7433",
            "fax_number": "918-540-7474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 2ND AVE SW",
            "city": "MIAMI",
            "state": "OK",
            "postal_code": "743546830",
            "telephone_number": "918-540-7433",
            "fax_number": "918-540-7474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOGAN",
        "first_name": "MARY",
        "middle_name": "MAURICELLA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "1125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "LAUCHNER",
            "middle_name": "MAURICELLA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Miami, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.