Individual provider Active NPI

Mary Alice Lavin, MSW, LCSW

  • Clinical Social Worker
  • Skokie, IL
National Provider Identifier
1578820486
Registry record updated Jan 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.014374 Issued in IL
Practice address
8324 Skokie Blvd
Skokie, IL 60077-2545
Phone
(847) 933-0051
NPI assigned
Apr 16, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 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 149.014374 IL Primary

Addresses

Primary practice location

8324 Skokie Blvd
Skokie, IL 60077-2545

Mailing address

2521 Thayer St
Evanston, IL 60201-1319
Phone (773) 368-1506

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.014374ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1334534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358985600000",
    "number": "1578820486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2521 THAYER ST",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011319",
            "telephone_number": "773-368-1506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8324 SKOKIE BLVD",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600772545",
            "telephone_number": "847-933-0051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVIN",
        "first_name": "MARY",
        "middle_name": "ALICE",
        "name_prefix": "Ms.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-16",
        "last_updated": "2013-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.014374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2013; 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.