Mary Anita Provence, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34003940A Issued in IN

Practice address

5023 E 56TH St
Indianapolis, IN 46226-1474

Phone

(317) 253-7387

Fax

(317) 253-7388

NPI assigned

Apr 20, 2012

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Green House and Associates Inc

  • Psychologist
  • McCordsville, IN
  • NPI 1558316463

  Clinical

  NPD (past)
• Greenhouse and Associates Inc.

  • Clinical Psychologist
  • Indianapolis, IN
  • NPI 1114237336
  NPD (past)

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

{
    "created_epoch": "1334880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334880000000",
    "number": "1326305814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 55107",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462050107",
            "telephone_number": "317-253-7387",
            "fax_number": "317-253-7388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5023 E 56TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462261474",
            "telephone_number": "317-253-7387",
            "fax_number": "317-253-7388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROVENCE",
        "first_name": "MARY",
        "middle_name": "ANITA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-20",
        "last_updated": "2012-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34003940A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Protected Provision Homecare LLC
• Stella Protopapas, MD, MPH
• Gretchen Sophia Prout
• John William Prout III, PHARMD
• Elizabeth J Proven, M.A., CCC-SLP
• Christian Provenza
• Providence Medical Associates LLC
• Providing Ease at Home Care Services, LLC
• Providing Ease Home Health, LLC
• Meredith Price Provost, MD

• Clinical Social Worker in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2012; 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.