Active NPI
Mary L Fair, LCSW
- Clinical Social Worker
- Haverford, PA
National Provider Identifier
1700245180
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CW018702
- Practice address
- 600 Haverford Rd
Suite 201
Haverford, PA 19041-1139 - Phone
- (610) 664-2524
- NPI assigned
- Feb 15, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CW018702 | PA | Primary |
Addresses
Primary practice location
600 Haverford Rd
Suite 201
Haverford, PA 19041-1139
Mailing address
2223 S Colorado St
Philadelphia, PA 19145-3808
Phone (848) 333-5455
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 9, 2025 through Jan 9, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CW018702 | PA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1455494400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1455494400000",
"number": "1700245180",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2223 S COLORADO ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191453808",
"telephone_number": "848-333-5455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 HAVERFORD RD",
"address_2": "SUITE 201",
"city": "HAVERFORD",
"state": "PA",
"postal_code": "190411139",
"telephone_number": "610-664-2524"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAIR",
"first_name": "MARY",
"middle_name": "L",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-02-15",
"last_updated": "2016-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "PA",
"license": "CW018702",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Haverford, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.