Individual provider Active NPI

Marsonne Denise Myers, LCSW, CADC

  • Clinical Social Worker
  • Wheaton, IL
National Provider Identifier
1306137039
Registry record updated Apr 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.014635 Issued in IL
Practice address
1725 S Naperville Rd
Ste 206
Wheaton, IL 60189-5855
Phone
(630) 653-6441
Fax
(630) 653-8409
NPI assigned
Apr 28, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2016

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 149.014635 IL Primary

Addresses

Primary practice location

1725 S Naperville Rd
Ste 206
Wheaton, IL 60189-5855

Mailing address

121 N Cross St
Unit 534
Wheaton, IL 60187-5368
Phone (630) 723-1762

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

LicenseStateTypeSpecialty
149.014635ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1303948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460505600000",
    "number": "1306137039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 N CROSS ST",
            "address_2": "UNIT 534",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601875368",
            "telephone_number": "630-723-1762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 S NAPERVILLE RD",
            "address_2": "STE 206",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601895855",
            "telephone_number": "630-653-6441",
            "fax_number": "630-653-8409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "MARSONNE",
        "middle_name": "DENISE",
        "credential": "LCSW, CADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-28",
        "last_updated": "2016-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.014635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2016; 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.