Mary Ellen Withers, LCSW, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

007177 Issued in IA

Practice address

137 N Oak Park Ave
Suite#408-1
Oak Park, IL 60301-1344

Phone

(708) 209-8560

NPI assigned

Mar 31, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Maye Center LLC

  • Community/Behavioral Health Agency
  • Oak Park, IL
  • NPI 1184054769
  Medicare reassignment NPD Authorized official
• Plains Area Mental Health, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Le Mars, IA
  • NPI 1356198147
  NPD (past)
• Plains Area Mental Health, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Le Mars, IA
  • NPI 1801867734
  NPD (past)

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

{
    "created_epoch": "1269993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371081600000",
    "number": "1194040329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 N OAK PARK AVE",
            "address_2": "SUITE#408-1",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011344",
            "telephone_number": "708-209-8560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 N OAK PARK AVE",
            "address_2": "SUITE#408-1",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011344",
            "telephone_number": "708-209-8560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITHERS",
        "first_name": "MARY",
        "middle_name": "ELLEN",
        "credential": "LCSW, LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-31",
        "last_updated": "2013-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "007177",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.005998",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leah Wisard
• Wisdom for the Journey, LLC
• Wesley Charles Wise, DDS
• Lisa H Wister, OT
• With Open Arms
• Heather Witthoff, MSW, LCSW
• Andrew Wojda, LCSW
• Wolff Clinical Group PLLC
• Kara E Wolff, PHD
• Elizabeth Marie Wollensak, D.O.

• Clinical Social Worker in Oak Park, IL
• Providers in Oak Park, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.