Mary T Deering, ACSW, LCSW, CADC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149007398 Issued in IL

Practice address

1205 N Sterling Ave
117
Palatine, IL 60067-8458

Phone

(630) 363-5328

NPI assigned

Jul 3, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Mary T. Cherullo Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1341273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341273600000",
    "number": "1831453968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 N STERLING AVE",
            "address_2": "117",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600678458",
            "telephone_number": "630-363-5328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 N STERLING AVE",
            "address_2": "117",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600678458",
            "telephone_number": "630-363-5328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEERING",
        "first_name": "MARY",
        "middle_name": "T",
        "credential": "ACSW, LCSW, CADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-03",
        "last_updated": "2012-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "27761",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149007398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "CHERULLO",
            "middle_name": "T.",
            "credential": "LCSW, CADC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ela Dargiel, P.T.
• Kathleen Daun
• Heather Marie Davalle
• Luis M Davis, MD
• Katelyn Decker
• Tatyana Degtyareva
• Loredana Tatiana Deichl, FNP-C
• Jonathan Delvicario, DC
• Carrah Demos, LCPC
• Dent Purity Medical LLC

• Clinical Social Worker in Palatine, IL
• Providers in Palatine, 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 Jul 3, 2012; 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.