Individual provider Active NPI

Mary Lee Muller

  • Clinical Social Worker
  • Mandeville, LA
National Provider Identifier
1689056590
Registry record updated Jun 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7575 Issued in LA
Practice address
633 Asbury Dr
Suite a
Mandeville, LA 70471-6511
Phone
(504) 723-0881
NPI assigned
Jun 26, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2015

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 7575 LA Primary

Addresses

Primary practice location

633 Asbury Dr
Suite a
Mandeville, LA 70471-6511

Mailing address

3524 Lake Trail Dr
Kenner, LA 70065-3310
Phone (504) 723-0881

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20170403002026 LA Practitioner - Clinical Social Worker 9032495122 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4919 Canal St
Suite 204
New Orleans, LA 70119-5847
Phone (504) 723-0881

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7575LAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Family Center Clinical CurrentSince Nov 6, 2016 Accepting new patients
MLM Therapy Services LLC CurrentSince Aug 11, 2016 Accepting new patients

Locations

110 Veterans Memorial Blvd
Ste 425
Metairie, LA 70005
Phone (504) 838-8283

110 Veterans Memorial Blvd
Metairie, LA 70005
Phone (504) 838-8283

4919 Canal St
Ste 204
New Orleans, LA 70119
Phone (504) 302-7771

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": "1435276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435276800000",
    "number": "1689056590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3524 LAKE TRAIL DR",
            "city": "KENNER",
            "state": "LA",
            "postal_code": "700653310",
            "telephone_number": "504-723-0881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 ASBURY DR",
            "address_2": "SUITE A",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704716511",
            "telephone_number": "504-723-0881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLER",
        "first_name": "MARY",
        "middle_name": "LEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-26",
        "last_updated": "2015-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "7575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mandeville, LA

Sources for this page

Verify at the official NPI Registry.