Active NPI
Mary Jo Adler, MSSW LCSW
- Clinical Social Worker
- Menomonie, WI
National Provider Identifier
1881633196
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 2372-123
- Practice address
- 808 Main St E
Menomonie, WI 54751-2735 - Phone
- (715) 232-1116
- NPI assigned
- Jun 5, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2372-123 | WI | Primary |
Addresses
Primary practice location
808 Main St E
Menomonie, WI 54751-2735
Mailing address
403 Summit Ave
Eau Claire, WI 54701-4805
Phone (715) 834-9744
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 18936 | Other | MN | MMSI PROVIDER NUMBER |
| 39563700 | Medicaid | WI | |
| 1029428 | Other | WI | PREFERREDONE PIN |
| 44245 | Other | WI | SECURITY HEALTH PLAN ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2372-123 | WI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Dunn | Clinical | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Menomonie, WI
- NPI 1588667406
Clinical
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149465600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1881633196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "403 SUMMIT AVE",
"city": "EAU CLAIRE",
"state": "WI",
"postal_code": "547014805",
"telephone_number": "715-834-9744"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "808 MAIN ST E",
"city": "MENOMONIE",
"state": "WI",
"postal_code": "547512735",
"telephone_number": "715-232-1116"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADLER",
"first_name": "MARY",
"middle_name": "JO",
"name_prefix": "Ms.",
"credential": "MSSW LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-05",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WI",
"license": "2372-123",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MMSI PROVIDER NUMBER",
"identifier": "18936",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "39563700",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERREDONE PIN",
"identifier": "1029428",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SECURITY HEALTH PLAN ID",
"identifier": "44245",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Menomonie, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.