NPIMap

Individual provider Active NPI

Mary Ann Clendenin, LCSW

  • Clinical Social Worker
  • Tucson, AZ
National Provider Identifier
1891764544
Registry record updated Jan 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-12846 Issued in AZ
Practice address
899 N Wilmot Rd Ste B
Tucson, AZ 85711-1712
Phone
(520) 290-1100
Fax
(520) 290-8997
NPI assigned
Mar 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LC7363 ME
Clinical Social Worker 1041C0700X LCSW-12846 AZ Primary

Addresses

Primary practice location

899 N Wilmot Rd Ste B
Tucson, AZ 85711-1712

Mailing address

PO Box 188
Marana, AZ 85653-0188
Phone (520) 682-4111

Other practice location 1

50 Moody St
Saco, ME 04072-1536
Phone (207) 294-4657

Other identifiers 1

IdentifierTypeStateIssuer
571662MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140224000862 AZ Practitioner - Clinical Social Worker 8325073596 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marana Health Center IncGroup PAC ID 2365348091, 114 clinicians

Practice addresses (Care Compare)

13395 N Marana Main St
Marana, AZ 85653-7008

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-12846AZMDClinical Social Worker
LC7363MEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Marana Health Center Inc CurrentSince May 6, 2019 Accepting new patients
Marana Health Center, Inc CurrentSince May 6, 2019 Accepting new patients
Marana Health Center, Inc Past Accepting new patients
El Rio Santa Cruz Neighborhood Health Center Past Accepting new patients

Locations

13395 N Marana Main St
Marana, AZ 85653
Phone (520) 616-6200

13395 N Marana Main St
Bldg B
Marana, AZ 85653
Phone (520) 682-1091

899 N Wilmot Rd
Ste B
Tucson, AZ 85711
Phone (520) 290-1100

2945 W Ina Rd
Ste 215
Tucson, AZ 85741

899 N Wilmot Rd
Tucson, AZ 85711
Phone (520) 290-1100

3690 S Park Ave
Ste 805
Tucson, AZ 85713
Phone (520) 616-1560

Interoperability endpoints

  • Direct secure messaging: mary.clendenin.1@32652.direct.athenahealth.com

Organizations & group practices 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610150400000",
    "number": "1891764544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 188",
            "city": "MARANA",
            "state": "AZ",
            "postal_code": "856530188",
            "telephone_number": "520-682-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "899 N WILMOT RD STE B",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857111712",
            "telephone_number": "520-290-1100",
            "fax_number": "520-290-8997"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 Moody St",
            "address_purpose": "LOCATION",
            "city": "Saco",
            "state": "ME",
            "postal_code": "040721536",
            "country_code": "US",
            "telephone_number": "207-294-4657",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLENDENIN",
        "first_name": "MARY",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-15",
        "last_updated": "2021-01-09",
        "certification_date": "2021-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC7363",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-12846",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "571662",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.