Mary Elizabeth Jarvis, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6628 Issued in MN

Practice address

1821 University Ave W Ste N187
Saint Paul, MN 55104-2814

Phone

(651) 603-9540

Fax

(651) 603-9543

NPI assigned

Jan 4, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ms. Mary Elizabeth Jarvis-Pribnow Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391731200000",
    "number": "1326195256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1821 UNIVERSITY AVE W STE N187",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551042814",
            "telephone_number": "651-603-9540",
            "fax_number": "651-603-9543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 UNIVERSITY AVE W STE N187",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551042814",
            "telephone_number": "651-603-9540",
            "fax_number": "651-603-9543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARVIS",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2014-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "6628",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "442899400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "JARVIS-PRIBNOW",
            "middle_name": "ELIZABETH",
            "prefix": "MS.",
            "credential": "LICSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Stephanie A Jarrett
• Annika Suzanne Jarvela
• Erika Jarvey, PA-C
• Larissa Rose Jarvis, CNM
• Laura Jarvis, PA-C
• Sarah Anne Jasa
• Susan I Jasko, LICSW
• Jason a Smith DC PA
• Katie Ann Jasper, MA, CN
• Jill Jasperson, PA-C

• Clinical Social Worker in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2014; 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.