Individual provider Active NPI

Mae Maurer-Rogers, LADC LICSW

  • Addiction (Substance Use Disorder) Counselor
  • Paynesville, MN
National Provider Identifier
1386113058
Registry record updated Sep 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
304336 Issued in MN
Practice address
109 Washburne Ave
Paynesville, MN 56362-1640
Phone
(320) 296-1121
NPI assigned
Nov 24, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 18047 MN
Addiction (Substance Use Disorder) Counselor 101YA0400X 304336 MN Primary

Addresses

Primary practice location

109 Washburne Ave
Paynesville, MN 56362-1640

Mailing address

421 E 4TH St
Litchfield, MN 55355-2208
Phone (320) 296-1121

Other practice location 1

110 N Sibley Ave
Litchfield, MN 55355-2185
Phone (320) 296-1121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
304336MNMDAddiction (Substance Use Disorder) Counselor
18047MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Recovery Center LLC Addiction (Substance Use Disorder) Current Accepting new patients
Invisible Wounds LLC CurrentSince Sep 15, 2019 Accepting new patients
Recovery Center LLC Addiction (Substance Use Disorder) CurrentSince Mar 1, 2020 Accepting new patients

Locations

110 N Sibley Ave
Litchfield, MN 55355
Phone (320) 296-1121

109 Washburne Ave
Paynesville, MN 56362
Phone (320) 243-1599

Organizations & group practices 3

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": "1543017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568246400000",
    "number": "1386113058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 E 4TH ST",
            "city": "LITCHFIELD",
            "state": "MN",
            "postal_code": "553552208",
            "telephone_number": "320-296-1121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 WASHBURNE AVE",
            "city": "PAYNESVILLE",
            "state": "MN",
            "postal_code": "563621640",
            "telephone_number": "320-296-1121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 N Sibley Ave",
            "address_purpose": "LOCATION",
            "city": "Litchfield",
            "state": "MN",
            "postal_code": "553552185",
            "country_code": "US",
            "telephone_number": "320-296-1121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAURER-ROGERS",
        "first_name": "MAE",
        "credential": "LADC LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-24",
        "last_updated": "2019-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "18047",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "304336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paynesville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2019; 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.