Individual provider Active NPI

Mary Elaine Marlin, LCSW-P

  • Clinical Social Worker
  • Tulsa, OK
National Provider Identifier
1871008565
Registry record updated Dec 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
4636 S Harvard Ave
Tulsa, OK 74135-2908
Phone
(918) 382-7300
NPI assigned
Dec 4, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2017

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 Primary

Addresses

Primary practice location

4636 S Harvard Ave
Tulsa, OK 74135-2908

Mailing address

5916 E 23Rd St
Tulsa, OK 74114-3805
Phone (405) 651-7673

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20240405002868 OK Practitioner - Clinical Social Worker 7214375450 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Creoks Mental Health Services CurrentSince Feb 25, 2024 Accepting new patients
Creoks Mental Health Services CurrentSince Feb 25, 2024 Accepting new patients

Locations

4103 S Yale Ave
Ste B
Tulsa, OK 74135
Phone (918) 382-7302

4636 S Harvard Ave
Tulsa, OK 74135
Phone (918) 216-4622

109 S Harrill Ave
Wagoner, OK 74467
Phone (918) 485-0242

Organizations & group practices 2

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": "1512345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512345600000",
    "number": "1871008565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5916 E 23RD ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741143805",
            "telephone_number": "405-651-7673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4636 S HARVARD AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352908",
            "telephone_number": "918-382-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARLIN",
        "first_name": "MARY",
        "middle_name": "ELAINE",
        "name_prefix": "Mrs.",
        "credential": "LCSW-P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-04",
        "last_updated": "2017-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.