Individual provider Active NPI

Mary Christine Fritz-Parker, LCSW

  • Clinical Social Worker
  • Alton, IL
National Provider Identifier
1366518250
Registry record updated Jul 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.010834 Issued in IL
Practice address
601 E 3Rd St Ste 302
Alton, IL 62002-6318
Phone
(618) 225-9956
Fax
(618) 465-9796
NPI assigned
Nov 24, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2008

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 149.010834 IL Primary

Addresses

Primary practice location

601 E 3Rd St Ste 302
Alton, IL 62002-6318

Mailing address

601 E 3Rd St Ste 302
Alton, IL 62002-6318
Phone (618) 225-9956

Other identifiers 2

IdentifierTypeStateIssuer
06032194OtherILPROVIDER#FORBCBSOF IL
028182OtherILVMC BEHAVIORAL HEALTHCARE SERVICES

Other names 1

  • Ms. Mary Christine Fritz Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20061221000413 IL Practitioner - Clinical Social Worker 3779583786 Practice locations: Alton, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

312 Piasa St
Alton, IL 62002-6233
Phone (618) 225-9956

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.010834ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216684800000",
    "number": "1366518250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 E 3RD ST STE 302",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026318",
            "telephone_number": "618-225-9956",
            "fax_number": "618-465-9796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E 3RD ST STE 302",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026318",
            "telephone_number": "618-225-9956",
            "fax_number": "618-465-9796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRITZ-PARKER",
        "first_name": "MARY",
        "middle_name": "CHRISTINE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-24",
        "last_updated": "2008-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.010834",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER#FORBCBSOF IL",
            "identifier": "06032194",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VMC BEHAVIORAL HEALTHCARE SERVICES",
            "identifier": "028182",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "FRITZ",
            "middle_name": "CHRISTINE",
            "prefix": "MS.",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Alton, IL

Sources for this page

Verify at the official NPI Registry.