Mary Alice Reed, MSW, LCSW, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34001071 Issued in IN

Legal business name

MARY ALICE REED, MSW, LCSW, LLC

Practice address

1910 Saint Joe Center Rd Ste 42
Fort Wayne, IN 46825

Phone

(260) 267-0497

Fax

(260) 960-9492

NPI assigned

Aug 18, 2016

Last updated

Aug 11, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mary Alice Reed, MSW, LCSWNPI 1881952893

Title

Licensed Clinical Social Worker

Phone

(260) 267-0497

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mary Alice Reed, LCSW

  • Clinical Social Worker
  • Fort Wayne, IN
  • NPI 1881952893
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1471478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533945600000",
    "number": "1376098491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 SAINT JOE CENTER RD STE 42",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468255000",
            "telephone_number": "260-267-0497",
            "fax_number": "260-960-9492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 SAINT JOE CENTER RD STE 42",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46825",
            "telephone_number": "260-267-0497",
            "fax_number": "260-960-9492"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10315 Dawsons Creek Blvd Ste E",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468251912",
            "country_code": "US",
            "telephone_number": "260-387-6340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MARY ALICE REED, MSW, LCSW, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-18",
        "last_updated": "2018-08-11",
        "status": "A",
        "authorized_official_last_name": "REED",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ALICE",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "260-267-0497",
        "authorized_official_credential": "MSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34001071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Fort Wayne, IN
• Providers in Fort Wayne, 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 Aug 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.