Mary Funke, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

02500 Issued in IA

Practice address

709 W Main St
Manchester, IA 52057-1526

Phone

(563) 927-7330

Fax

(563) 927-7409

NPI assigned

Apr 10, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Abbe Management Corp

  dba Associates for Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hiawatha, IA
  • NPI 1811998859
  NPD (past)
• Delaware County Memorial Hospital

  dba Backbone Area Counseling Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Manchester, IA
  • NPI 1982667929
  NPD (past)

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851354864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 W MAIN ST",
            "city": "MANCHESTER",
            "state": "IA",
            "postal_code": "520571526",
            "telephone_number": "563-927-7330",
            "fax_number": "563-927-7409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 W MAIN ST",
            "city": "MANCHESTER",
            "state": "IA",
            "postal_code": "520571526",
            "telephone_number": "563-927-7330",
            "fax_number": "563-927-7409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNKE",
        "first_name": "MARY",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "02500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS",
            "identifier": "248730",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0091637",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCIA",
            "identifier": "09971",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "IA0151",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Elaine Fangman, PA-C
• Lucas Richard Fangmann, DPT, LAT, ATC
• Samantha Madeline Whei Fitzgerald, MD
• Barry Francois
• Full Circle Physical Therapy, LLC
• Dawn M Gaffney, DDS
• Katherine Therese Gansen, ARNP, FNP-BC
• Shelby Gaylor, CRNA
• Timothy P Gerst, M.D.
• Darrell Ginsberg, D.M.D.

• Clinical Social Worker in Manchester, IA
• Providers in Manchester, IA by specialty
• Clinical Social Worker in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.