Marymac Child Development

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

Legal business name

MARYMAC CHILD DEVELOPMENT

Doing business as

MaryMac Child Development

Practice address

3996 Warrensville Center Rd
Warrensville Heights, OH 44122-6703

Phone

(216) 466-0215

NPI assigned

Jun 26, 2023

Organization subpart

No

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

Authorized official

Name

Monique Decluett, LPNNPI 1588083877

Title

LPN

Phone

(216) 296-1240

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• MaryMac Child Development Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Monique Decluett, LPN

  • Licensed Practical Nurse
  • Bedford Heights, OH
  • NPI 1588083877
  NPD Authorized official

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

{
    "created_epoch": "1687737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687737600000",
    "number": "1366128100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3996 WARRENSVILLE CENTER RD",
            "city": "WARRENSVILLE HEIGHTS",
            "state": "OH",
            "postal_code": "441226703",
            "telephone_number": "216-466-0215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3996 WARRENSVILLE CENTER RD",
            "city": "WARRENSVILLE HEIGHTS",
            "state": "OH",
            "postal_code": "441226703",
            "telephone_number": "216-466-0215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYMAC CHILD DEVELOPMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-26",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A",
        "authorized_official_last_name": "DECLUETT",
        "authorized_official_first_name": "MONIQUE",
        "authorized_official_title_or_position": "LPN",
        "authorized_official_telephone_number": "216-296-1240",
        "authorized_official_credential": "LPN"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Licensed Practical Nurse",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962197871",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MaryMac Child Development",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Manuel Garcia Prosthetics Lab., Inc. (Manuel Garcia Prosthetic & Orthotic Centers)
• Allison Markert, M.A. CCC/SLP
• John Marotta
• Marilyn J Marschall-Rowley, CNP
• Keri Martin
• Carol Masso
• Ranisha Masters
• Neethu Mathew
• Crystal Mathis
• James Matosky

• Licensed Practical Nurse in Warrensville Heights, OH
• Providers in Warrensville Heights, OH by specialty
• Licensed Practical Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; 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.