Individual provider Active NPI

Mary Ann Storie, LCSW

  • Clinical Social Worker
  • Joliet, IL
National Provider Identifier
1720098742
Registry record updated Apr 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
300 Republic Ave
Joliet, IL 60435-6520
Phone
(815) 725-1440
Fax
(815) 725-1550
NPI assigned
Aug 9, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 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 IL Primary

Addresses

Primary practice location

300 Republic Ave
Joliet, IL 60435-6520

Mailing address

1733 S Lalonde Ave
Lombard, IL 60148
Phone (815) 725-1440

Other identifiers 2

IdentifierTypeStateIssuer
02232165OtherILBLUE CROSS BLUE SHIELD
0007689557OtherILAETNA

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
149007212ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Nasr LTD Clinical PastSince Mar 1, 2006 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207267200000",
    "number": "1720098742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1733 S LALONDE AVE",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "60148",
            "telephone_number": "815-725-1440",
            "fax_number": "815-725-1550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 REPUBLIC AVE",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604356520",
            "telephone_number": "815-725-1440",
            "fax_number": "815-725-1550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STORIE",
        "first_name": "MARY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-09",
        "last_updated": "2008-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "02232165",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0007689557",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 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.