Individual provider Active NPI

Holly Jean Mareski, LCSW, CADC

  • Clinical Social Worker
  • Lombard, IL
National Provider Identifier
1699233825
Registry record updated Mar 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
450 E 22ND St Ste 150
Lombard, IL 60148-6118
Phone
(630) 930-3477
NPI assigned
Mar 6, 2019
Last updated
Mar 6, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X NU
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

450 E 22ND St Ste 150
Lombard, IL 60148-6118

Mailing address

16W639 3Rd Ave
Bensenville, IL 60106-2327
Phone (630) 930-3477

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
I20190822000364 IL Practitioner - Clinical Social Worker 4789912205 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Madrigal Consulting and Counseling LLPGroup PAC ID 8820336563, 6 clinicians

Practice addresses (Care Compare)

450 E 22ND St
Suite 158
Lombard, IL 60148-6175

450 W 22ND St
Suite 158
Lombard, IL 60148-4891
Phone (630) 474-3900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Madrigal Consulting and Counseling LLP Clinical CurrentSince Jul 30, 2019 Accepting new patients

Locations

450 E 22nd St
Ste 150
Lombard, IL 60148
Phone (630) 426-9279

450 E 22nd St
Ste 158
Lombard, IL 60148
Phone (630) 474-3900

Interoperability endpoints

  • Direct secure messaging: holly.mareski.p1@direct.gefcc.nextgenshare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1551830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551830400000",
    "number": "1699233825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16W639 3RD AVE",
            "city": "BENSENVILLE",
            "state": "IL",
            "postal_code": "601062327",
            "telephone_number": "630-930-3477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 E 22ND ST STE 150",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601486118",
            "telephone_number": "630-930-3477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARESKI",
        "first_name": "HOLLY",
        "middle_name": "JEAN",
        "credential": "LCSW, CADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-06",
        "last_updated": "2019-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lombard, IL

Sources for this page

Verify at the official NPI Registry.