Mary Jan Treadwell, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

1701 White Street
McComb, MS 39648

Phone

(601) 249-4228

Fax

(601) 249-4244

NPI assigned

Jun 1, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Genesis Behavioral Health Services

  • Psychiatry Physician
  • Baton Rouge, LA
  • NPI 1588345201

  Clinical

  NPD
• Southwest Mississippi Mental Health Mental Retardation Commission

  • Social Worker
  • McComb, MS
  • NPI 1366694820
  NPD (past)
• SW Ms Mental Health Mental Retardation Commission

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • McComb, MS
  • NPI 1184662694
  NPD (past)
• Genesis Behavioral Health Services

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Baton Rouge, LA
  • NPI 1093195141
  NPD (past)

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376438400000",
    "number": "1730183062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 768",
            "address_2": "1701 WHITE STREET",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "39648",
            "telephone_number": "601-249-4228",
            "fax_number": "601-249-4244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 WHITE STREET",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "39648",
            "telephone_number": "601-249-4228",
            "fax_number": "601-249-4244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREADWELL",
        "first_name": "MARY",
        "middle_name": "JAN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-01",
        "last_updated": "2013-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "09416",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Tomba
• Total Quality Healthcare
• Kelly Suong Tram, PHARM.D
• Brook Travis
• Joshua Blake Travis, DNP
• Brandy Trebotich-Smith
• Tri-State Medical Home Health
• Victor Trinchera, PTA
• Emily Troxler, DPT
• Benda Truvillion

• Clinical Social Worker in McComb, MS
• Providers in McComb, MS by specialty
• Clinical Social Worker in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.