Individual provider Active NPI

Mary Lynn Meyers, LCSW, MSW

  • Clinical Social Worker
  • Wilmette, IL
National Provider Identifier
1609097146
Registry record updated Jan 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.014424 Issued in IL
Practice address
1167 Wilmette Ave
Suite 207
Wilmette, IL 60091-2643
Phone
(847) 828-6066
NPI assigned
May 1, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2016

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 149.014424 IL Primary

Addresses

Primary practice location

1167 Wilmette Ave
Suite 207
Wilmette, IL 60091-2643

Mailing address

2654 West Lake Avenuee
Glenview, IL 60026-2643
Phone (847) 828-6066

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20120208000690 IL Practitioner - Clinical Social Worker 8729245436 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

825 Green Bay Rd
Suite 210
Wilmette, IL 60091-2500
Phone (847) 828-6066

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.014424ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Service Center of Wilmette Glenview Northbrook Kenilworth Clinical PastSince Nov 9, 2022 Accepting new patients

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": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452816000000",
    "number": "1609097146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2654 WEST LAKE AVENUEE",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600262643",
            "telephone_number": "847-828-6066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1167 WILMETTE AVE",
            "address_2": "SUITE 207",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600912643",
            "telephone_number": "847-828-6066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYERS",
        "first_name": "MARY LYNN",
        "name_prefix": "Ms.",
        "credential": "LCSW, MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2016-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.014424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmette, IL

Sources for this page

Verify at the official NPI Registry.