Individual provider Active NPI

Mary C. Ball, LCSW

  • Clinical Social Worker
  • South Elgin, IL
National Provider Identifier
1174799027
Registry record updated May 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149-009247 Issued in IL
Practice address
611 W Thornwood Dr
South Elgin, IL 60177-3733
Phone
(847) 717-5430
Fax
(847) 695-4394
NPI assigned
May 1, 2008
Last updated
May 1, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2008

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 149-009247 IL Primary

Addresses

Primary practice location

611 W Thornwood Dr
South Elgin, IL 60177-3733

Mailing address

611 W Thornwood Dr
South Elgin, IL 60177-3733
Phone (847) 717-5430

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
149-009247ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cove Counseling PC Clinical Past Accepting new patients

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": "1209600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209600000000",
    "number": "1174799027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W THORNWOOD DR",
            "city": "SOUTH ELGIN",
            "state": "IL",
            "postal_code": "601773733",
            "telephone_number": "847-717-5430",
            "fax_number": "847-695-4394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 W THORNWOOD DR",
            "city": "SOUTH ELGIN",
            "state": "IL",
            "postal_code": "601773733",
            "telephone_number": "847-717-5430",
            "fax_number": "847-695-4394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALL",
        "first_name": "MARY",
        "middle_name": "C.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-01",
        "last_updated": "2008-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149-009247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Elgin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2008; 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.