Maranda Anne Stachyra, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.010480 Issued in IL

Practice address

3600 South Water Tower Place
Mt. Vernon, IL 62864

Phone

(618) 244-0212

Fax

(618) 244-0535

NPI assigned

Jun 8, 2007

Last updated

May 7, 2019By the provider in NPPES

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 identifiers 1

Other names 1

• Maranda Anne Herbert Other name

Medicare fee-for-service enrollment

Enrolled in IL

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.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pathways Counseling and Consultation PLLC

  • Clinical Social Worker
  • Mount Vernon, IL
  • NPI 1275357006
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1181260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557187200000",
    "number": "1831392570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 SOUTH WATER TOWER PLACE",
            "city": "MT. VERNON",
            "state": "IL",
            "postal_code": "62864",
            "telephone_number": "618-244-0212",
            "fax_number": "618-244-0535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 SOUTH WATER TOWER PLACE",
            "city": "MT. VERNON",
            "state": "IL",
            "postal_code": "62864",
            "telephone_number": "618-244-0212",
            "fax_number": "618-244-0535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACHYRA",
        "first_name": "MARANDA",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-08",
        "last_updated": "2019-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.010480",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL LICENSE",
            "identifier": "149.010480",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARANDA",
            "last_name": "HERBERT",
            "middle_name": "ANNE",
            "credential": "LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Prateek Srinet, M.D.
• SSC Mount Vernon Operating Company LLC (Nature Trail Health Care Center)
• SSM Health Businesses (SSM Health at Home Hospice Glen Carbon)
• SSM Health Businesses (SSM Health at Home Home Health Glen Carbon)
• St. Louis JC Vamc
• Caleb Ryan Stanley
• Leeann Stanley, PT
• Jennifer Lynn Starr, FNP-C
• Andrea Stearns, NP
• Mary L. Stedelin, PT

• Clinical Social Worker in Mount Vernon, IL
• Providers in Mount Vernon, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.