Active NPI
Mary Lynn Mack, MOT, OTR/L
- Occupational Therapist
- Cuyahoga Falls, OH
National Provider Identifier
1487947677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT009714
- Practice address
- 420 Washington Ave
Cuyahoga Falls, OH 44221-2039 - Phone
- (330) 926-3930
- Fax
- (330) 926-3943
- NPI assigned
- May 19, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | |||
| Occupational Therapist | 225X00000X | OT009714 | OH | Primary |
Addresses
Primary practice location
420 Washington Ave
Cuyahoga Falls, OH 44221-2039
Mailing address
420 Washington Ave
Cuyahoga Falls, OH 44221-2039
Phone (330) 926-3930
Other practice location 1
312 Locust St
Akron, OH 44302-1801
Phone (330) 762-0591
Other names 1
- Miss Mary Lynn Bode
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
| License | State | Type | Specialty |
|---|---|---|---|
| OT009714 | OH | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Child Guidance & Family Solutions | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Adolescent and Children Mental Health Clinic/Center
- Akron, OH
- NPI 1922105147
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1305763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1487947677",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420 WASHINGTON AVE",
"city": "CUYAHOGA FALLS",
"state": "OH",
"postal_code": "442212039",
"telephone_number": "330-926-3930",
"fax_number": "330-926-3943"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 WASHINGTON AVE",
"city": "CUYAHOGA FALLS",
"state": "OH",
"postal_code": "442212039",
"telephone_number": "330-926-3930",
"fax_number": "330-926-3943"
}
],
"practiceLocations": [
{
"address_1": "312 Locust St",
"address_purpose": "LOCATION",
"city": "Akron",
"state": "OH",
"postal_code": "443021801",
"country_code": "US",
"telephone_number": "330-762-0591",
"fax_number": "330-762-2242",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MACK",
"first_name": "MARY",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "MOT, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-05-19",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "OH",
"license": "OT009714",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARY",
"last_name": "BODE",
"middle_name": "LYNN",
"prefix": "MISS",
"credential": "B.A.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Cuyahoga Falls, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.