Individual provider Active NPI

Marie S. Styles

  • Social Worker
  • Independence, MO
National Provider Identifier
1497220842
Registry record updated Apr 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
2018019025 Issued in MO
Practice address
4801 S Cliff Ave Ste 214a
Independence, MO 64055-7015
Phone
(816) 867-6868
Fax
(816) 875-4199
NPI assigned
Oct 11, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 2018019025 MO Primary

Addresses

Primary practice location

4801 S Cliff Ave Ste 214a
Independence, MO 64055-7015

Mailing address

PO Box 1577
Independence, MO 64055-0577
Phone (816) 875-6868

Other identifiers 1

IdentifierTypeStateIssuer
1497220842MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20220419002073 MO Practitioner - Clinical Social Worker 5395132476 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2018019025MOMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Breakthrough Counseling KC, LLC CurrentSince Mar 12, 2022 Accepting new patients
The Family Conservancy PastSince Dec 1, 2018 Accepting new patients

Locations

14200 E 32nd St S
Unit 1577
Independence, MO 64055

4801 S Cliff Ave
Ste 214A
Independence, MO 64055
Phone (816) 867-0584

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1539216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649289600000",
    "number": "1497220842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1577",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640550577",
            "telephone_number": "816-875-6868",
            "fax_number": "816-875-4199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 S CLIFF AVE STE 214A",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640557015",
            "telephone_number": "816-867-6868",
            "fax_number": "816-875-4199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STYLES",
        "first_name": "MARIE",
        "middle_name": "S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-11",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MO",
            "license": "2018019025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497220842",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, MO

Sources for this page

Verify at the official NPI Registry.