Individual provider Active NPI

Mary Cherry, LCSW

  • Clinical Social Worker
  • Geneva, IL
National Provider Identifier
1417091646
Registry record updated Feb 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149 012301 Issued in IL
Practice address
611 E State St Ste 600
Geneva, IL 60134-2300
Phone
(630) 399-2935
Fax
(630) 399-2935
NPI assigned
Feb 19, 2007
Last updated
Feb 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2024

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 012301 IL Primary

Addresses

Primary practice location

611 E State St Ste 600
Geneva, IL 60134-2300

Mailing address

PO Box 392
North Aurora, IL 60542-0138
Phone (630) 399-2935

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
I20070426000419 IL Practitioner - Clinical Social Worker 7416053160 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

611 E State St
Unit 600 Unit 610
Geneva, IL 60134-1804
Phone (630) 399-2935

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149 012301ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Valley Counseling Center PC Clinical CurrentSince Jan 1, 2013 Accepting new patients
Mary McMillan LCSW Clinical PastSince Jan 1, 1990 Accepting new patients
Lifecore SC Past Accepting new patients
Riverview Counseling Services, LTD. Clinical Past Accepting new patients

Locations

1601 N Farnsworth Ave
Aurora, IL 60505
Phone (630) 552-7166

611 E State St
Ste 600
Geneva, IL 60134
Phone (630) 208-8244

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708646400000",
    "number": "1417091646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 392",
            "city": "NORTH AURORA",
            "state": "IL",
            "postal_code": "605420138",
            "telephone_number": "630-399-2935",
            "fax_number": "815-727-4855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 E STATE ST STE 600",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601342300",
            "telephone_number": "630-399-2935",
            "fax_number": "630-399-2935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHERRY",
        "first_name": "MARY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-19",
        "last_updated": "2024-02-23",
        "certification_date": "2024-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149 012301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Geneva, IL

Sources for this page

Verify at the official NPI Registry.