Mary Marlene Maryanopolis, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW008952 Issued in GA

Practice address

1061 Harmon Ave
Fort Stewart, GA 31314-5641

Phone

(912) 435-6965

NPI assigned

May 3, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mary Marlene Hollis Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• 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

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

{
    "created_epoch": "1620000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734220800000",
    "number": "1801479373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1061 HARMON AVE",
            "city": "FORT STEWART",
            "state": "GA",
            "postal_code": "313145641",
            "telephone_number": "912-435-6965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1061 HARMON AVE",
            "city": "FORT STEWART",
            "state": "GA",
            "postal_code": "313145641",
            "telephone_number": "912-435-6965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARYANOPOLIS",
        "first_name": "MARY",
        "middle_name": "MARLENE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-03",
        "last_updated": "2024-12-15",
        "certification_date": "2024-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW008952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "HOLLIS",
            "middle_name": "MARLENE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lana Martin
• Stephanie Martin, RN
• Edwin Martinez
• Katie Marie Martinez, PHARMD
• Sonia Y Martinez, SOCIAL WORKER
• Anita Marie Marynowski, OTR/L
• Anthony Gabriel Massaro, DMD
• Amy Masters, OTD, OTR/L
• Nicholas John Mastromarino, PA-C
• Savannah Mathis

• Clinical Social Worker in Fort Stewart, GA
• Providers in Fort Stewart, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2024; 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.