Individual provider Active NPI

Mary J Morois, LCSW, ACSW

  • Clinical Social Worker
  • Indianapolis, IN
National Provider Identifier
1457353245
Registry record updated Apr 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34003359A Issued in IN
Practice address
1904 N Shortridge Rd
Indianapolis, IN 46219-2304
Phone
(317) 493-0968
NPI assigned
Aug 11, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2013

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 34003359A IN Primary

Addresses

Primary practice location

1904 N Shortridge Rd
Indianapolis, IN 46219-2304

Mailing address

1904 N Shortridge Rd
Indianapolis, IN 46219-2304
Phone (317) 493-0968

Other identifiers 1

IdentifierTypeStateIssuer
100073590MedicaidIN

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
34003359AINMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366156800000",
    "number": "1457353245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1904 N SHORTRIDGE RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462192304",
            "telephone_number": "317-493-0968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1904 N SHORTRIDGE RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462192304",
            "telephone_number": "317-493-0968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOROIS",
        "first_name": "MARY",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "LCSW, ACSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-11",
        "last_updated": "2013-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34003359A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100073590",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2013; 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.