Individual provider Active NPI

Martha P Fara, MSW

  • Clinical Social Worker
  • Naperville, IL
National Provider Identifier
1467733899
Registry record updated Aug 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.004756 Issued in IL
Practice address
113 E Van Buren Ave
Naperville, IL 60540-4947
Phone
(630) 947-2517
NPI assigned
Aug 30, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2011

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 149.004756 IL Primary

Addresses

Primary practice location

113 E Van Buren Ave
Naperville, IL 60540-4947

Mailing address

1079 Huntleigh Dr
Naperville, IL 60540-8208
Phone (630) 947-2517

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
149.004756ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1314662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314662400000",
    "number": "1467733899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1079 HUNTLEIGH DR",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605408208",
            "telephone_number": "630-947-2517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 E VAN BUREN AVE",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605404947",
            "telephone_number": "630-947-2517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARA",
        "first_name": "MARTHA",
        "middle_name": "P",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-30",
        "last_updated": "2011-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.004756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2011; 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.