Active NPI
Mary Alice Butler, LISW
- Clinical Social Worker
- Des Moines, IA
National Provider Identifier
1265574362
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 00910
- Practice address
- 2408 Beaver Ave
Des Moines, IA 50310-3984 - Phone
- (515) 274-4471
- NPI assigned
- Feb 13, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 00910 | IA | Primary |
Addresses
Primary practice location
2408 Beaver Ave
Des Moines, IA 50310-3984
Mailing address
2420 Beaver Ave
Des Moines, IA 50310-3904
Phone (515) 274-4471
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
| License | State | Type | Specialty |
|---|---|---|---|
| 00910 | IA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Elder Concerns LC | 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": "1171324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1265574362",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2420 BEAVER AVE",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503103904",
"telephone_number": "515-274-4471"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2408 BEAVER AVE",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503103984",
"telephone_number": "515-274-4471"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUTLER",
"first_name": "MARY ALICE",
"name_prefix": "Ms.",
"credential": "LISW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IA",
"license": "00910",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Des Moines, IA
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.