Mary Ann Korbly Shepard, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149011409 Issued in IL

Practice address

366 W Miner St Apt 1a
Arlington Heights, IL 60005-1386

Phone

(317) 690-0673

Fax

(847) 952-1374

NPI assigned

Apr 2, 2007

Last updated

Mar 13, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• The Mens Center Inc

  • Clinical Social Worker
  • Arlington Heights, IL
  • NPI 1154548022
  NPD (past)
• Wood Neuropsychology Associates LLC

  • Clinical Neuropsychologist
  • Rolling Meadows, IL
  • NPI 1033517412
  NPD (past)
• St. Vincent Hospital & Health Care Center, Inc.

  dba Ascension St. Vincent Pharmacy

  • Community/Retail Pharmacy
  • Indianapolis, IN
  • NPI 1194929646
  NPD (past)
• St. Vincent Hospital & Health Care Center, Inc.

  dba Ascension St. Vincent Stress Center

  • Psychiatry Physician
  • Indianapolis, IN
  • NPI 1689869893
  NPD (past)

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426204800000",
    "number": "1326168220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "366 W MINER ST APT 1A",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600051386",
            "telephone_number": "317-690-0673",
            "fax_number": "847-952-1374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "366 W MINER ST APT 1A",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600051386",
            "telephone_number": "317-690-0673",
            "fax_number": "847-952-1374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORBLY SHEPARD",
        "first_name": "MARY ANN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-02",
        "last_updated": "2015-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149011409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbara Konopka, DN
• Svetlana Konstantinovic, LCPC
• Lynn Marie Konzen
• Erin Kopeny, PA-C
• Kenneth Edward Korber, P.A.
• Tamara L. Kornas, APN-CRNA
• Rechna M. Korula, MD
• Courtney Kosiewicz
• Bonnie Joyce Koss, LCSW
• Tyler James Kostecki, PA-C

• Clinical Social Worker in Arlington Heights, IL
• Providers in Arlington Heights, 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 Mar 13, 2015; 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.