Individual provider Active NPI

Mary Jane M Demet, MSW, LCSW

  • Clinical Social Worker
  • Milwaukee, WI
National Provider Identifier
1841219169
Registry record updated Apr 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3960-123 Issued in WI
Practice address
731 N Jackson St
Ste 510
Milwaukee, WI 53202-4697
Phone
(414) 810-2256
Fax
(888) 266-8068
NPI assigned
Jul 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 3960-123 WI Primary

Addresses

Primary practice location

731 N Jackson St
Ste 510
Milwaukee, WI 53202-4697

Mailing address

731 N Jackson St
Ste 510
Milwaukee, WI 53202-4697
Phone (414) 810-2256

Other identifiers 1

IdentifierTypeStateIssuer
39783600MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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

Enrollment IDStateProvider typePAC IDDetails
I20060814000227 WI Practitioner - Clinical Social Worker 4688677636 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Loyola University of Chicago, Stritch School of Medicine, 1988
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

731 N Jackson St
Suite 510
Milwaukee, WI 53202-4697
Phone (414) 810-2256

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3960-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Psychology Consultants LLC CurrentSince May 1, 2018 Accepting new patients
Your Best Self Psychotherapy, LLP Clinical CurrentSince May 1, 2018 Accepting new patients
Psychiatric Consultants & Therapists, SC CurrentSince May 1, 2006 Accepting new patients

Locations

731 N Jackson St
Ste 510
Milwaukee, WI 53202
Phone (414) 431-4322

229 E Wisconsin Ave
Ste 60
Milwaukee, WI 53202
Phone (414) 224-3737

229 E Wisconsin Ave
Ste 600
Milwaukee, WI 53202
Phone (414) 224-3737

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523836800000",
    "number": "1841219169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 N JACKSON ST",
            "address_2": "STE 510",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532024697",
            "telephone_number": "414-810-2256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 N JACKSON ST",
            "address_2": "STE 510",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532024697",
            "telephone_number": "414-810-2256",
            "fax_number": "888-266-8068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMET",
        "first_name": "MARY JANE",
        "middle_name": "M",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2018-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "3960-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39783600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.