Individual provider Active NPI

Mary J Vontersch Hanno, MSW LISW

  • Clinical Social Worker
  • Sioux City, IA
National Provider Identifier
1336207976
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
762 Issued in IA
Practice address
3133 Floyd Blvd
Sioux City, IA 51108
Phone
(712) 239-0392
Fax
(712) 239-0824
NPI assigned
Dec 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 762 IA Primary

Addresses

Primary practice location

3133 Floyd Blvd
Sioux City, IA 51108

Mailing address

3133 Floyd Blvd
Sioux City, IA 51108
Phone (712) 239-0392

Other identifiers 3

IdentifierTypeStateIssuer
073590MedicaidNE
0242461MedicaidIA
41938OtherBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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

Enrollment IDStateProvider typePAC IDDetails
I20040326000824 IA Practitioner - Clinical Social Worker 4880586619 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3133 Floyd Blvd
Sioux City, IA 51108-1419
Phone (712) 239-0392

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00762IAMDClinical Psychologist
762IAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Patrick a. Walding DC PC CurrentSince Nov 26, 2017 Accepting new patients
Hanno Therapy Services Inc Clinical CurrentSince Oct 1, 2012 Accepting new patients

Locations

3133 Floyd Blvd
Sioux City, IA 51108
Phone (712) 239-0392

3439 Glen Oaks Blvd
Sioux City, IA 51104
Phone (712) 239-0392

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336207976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3133 FLOYD BLVD",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "51108",
            "telephone_number": "712-239-0392",
            "fax_number": "712-239-0824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3133 FLOYD BLVD",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "51108",
            "telephone_number": "712-239-0392",
            "fax_number": "712-239-0824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VONTERSCH HANNO",
        "first_name": "MARY",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "MSW LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "073590",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0242461",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "41938",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux City, IA

Sources for this page

Verify at the official NPI Registry.