Active NPI
Mary E Senn, MSW, LCSW, ACSW
- Clinical Social Worker
- Evanston, IL
National Provider Identifier
1275718272
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149.010876
- Practice address
- 1740 Ridge Ave
Suite 106
Evanston, IL 60201-5918 - Phone
- (847) 328-4074
- NPI assigned
- Jan 8, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 | 149.010876 | IL | Primary |
Addresses
Primary practice location
1740 Ridge Ave
Suite 106
Evanston, IL 60201-5918
Mailing address
1015 Florence Ave
Evanston, IL 60202-1150
Phone (847) 528-4099
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 9, 2023 through Oct 9, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149.010876 | IL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1199750400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353542400000",
"number": "1275718272",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1015 FLORENCE AVE",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602021150",
"telephone_number": "847-528-4099"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1740 RIDGE AVE",
"address_2": "SUITE 106",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602015918",
"telephone_number": "847-328-4074"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SENN",
"first_name": "MARY",
"middle_name": "E",
"credential": "MSW, LCSW, ACSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-01-08",
"last_updated": "2012-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149.010876",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Evanston, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.