Individual provider Active NPI

Mary F Grover, LCSW R ACSW

  • Clinical Social Worker
  • Buffalo, NY
National Provider Identifier
1467507111
Registry record updated Sep 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R0263321 Issued in NY
Practice address
1487 Main Street
Buffalo, NY 14209
Phone
(716) 881-2405
Fax
(716) 881-2425
NPI assigned
Jan 24, 2007
Last updated
Sep 16, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 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 R0263321 NY Primary

Addresses

Primary practice location

1487 Main Street
Buffalo, NY 14209

Mailing address

1487 Main Street
Buffalo, NY 14209
Phone (716) 881-2405

Other identifiers 1

IdentifierTypeStateIssuer
00357855MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20160628001949 NY Practitioner - Clinical Social Worker 3274762851 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Church Mission of Help of Western New York Inc.Group PAC ID 9931013059, 9 clinicians

Practice addresses (Care Compare)

153 W Utica St
Buffalo, NY 14222-2017
Phone (716) 884-7569

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26332NYMDAddiction (Substance Use Disorder) Counselor
R0263321NYMDClinical Social Worker
026332NYMDSports Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Child and Adolescent Treatment Services Inc Past Accepting new patients

Organizations & group practices 2

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": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379289600000",
    "number": "1467507111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1487 MAIN STREET",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "14209",
            "telephone_number": "716-881-2405",
            "fax_number": "716-881-2425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1487 MAIN STREET",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "14209",
            "telephone_number": "716-881-2405",
            "fax_number": "716-881-2425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROVER",
        "first_name": "MARY",
        "middle_name": "F",
        "name_prefix": "Ms.",
        "credential": "LCSW R  ACSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2013-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R0263321",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00357855",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.