Mary Katherine Soucek, M.S., M.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW12468 Issued in FL

Practice address

1940 Maravilla Ave
Fort Myers, FL 33901-7135

Phone

(239) 334-0222

Fax

(239) 334-0244

NPI assigned

May 29, 2012

Last updated

Jan 19, 2019By the provider in NPPES

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 identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Clinical Social Worker

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Dna Comprehensive Therapy Services LLCGroup PAC ID 2860619632, 446 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

87.43 of 100Reported as group

Quality

74.02

Promoting interoperability

100

Improvement activities

40

Cost

77.26

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Locations (25 of 37)

Interoperability endpoints

• Direct secure messaging: mary.soucek.1@13142.direct.athenahealth.com

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.

• Dna Comprehensive Therapy Services, LLC

  dba Elite DNA Therapy Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fort Myers, FL
  • NPI 1316363757

  Clinical

  Medicare reassignment Care Compare group NPD
• David Lawrence Mental Health Center, Inc

  • Community/Behavioral Health Agency
  • Naples, FL
  • NPI 1801891940
  Medicare reassignment NPD
• Bonita Springs Retirement Village, Inc.

  dba The Terraces at Bonita Springs

  • Skilled Nursing Facility
  • Bonita Springs, FL
  • NPI 1700126802
  NPD

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

{
    "created_epoch": "1338249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547856000000",
    "number": "1881954584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6360 TECHSTER BLVD",
            "address_2": "STE 1",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339664805",
            "telephone_number": "239-223-2751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 MARAVILLA AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339017135",
            "telephone_number": "239-334-0222",
            "fax_number": "239-334-0244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUCEK",
        "first_name": "MARY",
        "middle_name": "KATHERINE",
        "name_prefix": "Ms.",
        "credential": "M.S., M.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-29",
        "last_updated": "2019-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW12468",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "59-0192430",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kellyn Rachel Soto
• Melissa Lianne Soto
• Robyn Nicole Soto, APRN
• Henry Sotomayor
• Soublet Home Health Agency LLC
• Altagrace Souffrance
• Soul Community Center Inc
• Demi Soulet, PA-C
• Soundmind Music Therapy Inc.
• Jaqueline Sousa Carvalho, FNP-BC

• Clinical Social Worker in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.