Active NPI
Mary E Stahr, LCSW
- Clinical Social Worker
- Bradenton, FL
National Provider Identifier
1285854091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 1275
- Practice address
- 3657 Cortez Rd W
Suite 130
Bradenton, FL 34210-3106 - Phone
- (941) 758-1636
- Fax
- (941) 894-6224
- NPI assigned
- Apr 26, 2007
- 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 | 1275 | FL | Primary |
Addresses
Primary practice location
3657 Cortez Rd W
Suite 130
Bradenton, FL 34210-3106
Mailing address
3657 Cortez Rd W
Suite 130
Bradenton, FL 34210-3106
Phone (941) 758-1636
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1655961 | Other | FL | CIGNA |
| 29909 | Other | FL | AMERIGROUP VA |
| 606701 | Other | FL | AMERIHEALTH |
| Z2585 | Other | FL | BCBS |
| 0049888 | Other | FL | GHI |
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 |
|---|---|---|---|
| 1275 | FL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204848000000",
"number": "1285854091",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3657 CORTEZ RD W",
"address_2": "SUITE 130",
"city": "BRADENTON",
"state": "FL",
"postal_code": "342103106",
"telephone_number": "941-758-1636",
"fax_number": "941-894-6224"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3657 CORTEZ RD W",
"address_2": "SUITE 130",
"city": "BRADENTON",
"state": "FL",
"postal_code": "342103106",
"telephone_number": "941-758-1636",
"fax_number": "941-894-6224"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAHR",
"first_name": "MARY",
"middle_name": "E",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-26",
"last_updated": "2008-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "1275",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "1655961",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP VA",
"identifier": "29909",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIHEALTH",
"identifier": "606701",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "Z2585",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI",
"identifier": "0049888",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bradenton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.