Individual provider Active NPI

Mary E Streete, LCSW

  • Clinical Social Worker
  • Memphis, TN
National Provider Identifier
1487703542
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
IP490 Issued in TN
Practice address
670 Colonial Rd
Suite 5
Memphis, TN 38117-5160
Phone
(901) 681-0851
Fax
(901) 681-0872
NPI assigned
Jan 9, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 IP490 TN Primary

Addresses

Primary practice location

670 Colonial Rd
Suite 5
Memphis, TN 38117-5160

Mailing address

670 Colonial Rd
Suite 5
Memphis, TN 38117-5160
Phone (901) 681-0851

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
IP490TNMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487703542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 COLONIAL RD",
            "address_2": "SUITE 5",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381175160",
            "telephone_number": "901-681-0851",
            "fax_number": "901-681-0872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 COLONIAL RD",
            "address_2": "SUITE 5",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381175160",
            "telephone_number": "901-681-0851",
            "fax_number": "901-681-0872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STREETE",
        "first_name": "MARY",
        "middle_name": "E",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "IP490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.