Marcie Stover-Jividen, LSW

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

3010 E State Blvd
Fort Wayne, IN 46805-4700

Phone

(260) 471-2300

NPI assigned

May 12, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Center for Neurobehavioral Services Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fort Wayne, IN
  • NPI 1548275258
  NPD (past)

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

{
    "created_epoch": "1210550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210550400000",
    "number": "1720255441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9917 SAWTOOTH CT",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468043981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3010 E STATE BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468054700",
            "telephone_number": "260-471-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOVER-JIVIDEN",
        "first_name": "MARCIE",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-12",
        "last_updated": "2008-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clayton Stout
• Dawn Stout
• Maisie Stout
• Sara Mae Stout, NP-C
• Andre Byard Stovall, MD
• Catherine Straber, RBT
• Faelynne Strable
• Haley Strack, PA-C
• Jenny Strader, PT
• Diane L Straessle, P.T.

• Social Worker in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 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.