Individual provider Active NPI

Beth Fischer

  • Clinical Social Worker
  • Forest Park, IL
National Provider Identifier
1700043262
Registry record updated May 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149001344 Issued in IL
Practice address
320 Marengo Ave
Forest Park, IL 60130-1604
Phone
(708) 771-2680
NPI assigned
May 21, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2008

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 149001344 IL Primary

Addresses

Primary practice location

320 Marengo Ave
Forest Park, IL 60130-1604

Mailing address

320 Marengo Ave
Forest Park, IL 60130-1604
Phone (708) 771-2680

Other names 1

  • Ms. Mary Beth Fischer Professional name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
149001344ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211328000000",
    "number": "1700043262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 MARENGO AVE",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "601301604",
            "telephone_number": "708-771-2680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 MARENGO AVE",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "601301604",
            "telephone_number": "708-771-2680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISCHER",
        "first_name": "BETH",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-21",
        "last_updated": "2008-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149001344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "FISCHER",
            "middle_name": "BETH",
            "prefix": "MS.",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Forest Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2008; 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.