Individual provider Active NPI

Mary Rose Draper, MSW, LCSW

  • Clinical Social Worker
  • Marion, IN
National Provider Identifier
1891856399
Registry record updated Jun 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34004314A Issued in IN
Practice address
1700 E 38TH St
Marion, IN 46953-4568
Phone
(765) 674-3321
NPI assigned
Dec 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2026

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 34004314A IN Primary

Addresses

Primary practice location

1700 E 38TH St
Marion, IN 46953-4568

Mailing address

1732 S Hadley Rd
Fort Wayne, IN 46804-1458
Phone (260) 438-4905

Other identifiers 2

IdentifierTypeStateIssuer
000000324983OtherINANTHEM
200002660MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20040804000593 IN Practitioner - Clinical Social Worker 2961473863 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2200 Lake Ave
Suite 260
Fort Wayne, IN 46805-5300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34004314AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Rose LCSW, LLC CurrentSince Sep 18, 2023 Accepting new patients
Phoenix Associates Inc. Clinical CurrentSince Jun 26, 2012 Accepting new patients
Extended Care Specialists, Inc Clinical CurrentSince May 6, 2015 Accepting new patients
Hobson Psychiatric Services PC Clinical Past Accepting new patients

Locations

405 Airport North Office Park
#P
Fort Wayne, IN 46825
Phone (260) 623-0054

3512 Stellhorn Rd
Fort Wayne, IN 46815

405 Airport North Office Park
Fort Wayne, IN 46825
Phone (260) 440-0770

2200 Lake Ave
Ste 260
Fort Wayne, IN 46805
Phone (260) 424-0411

8398 Mississippi St
Fl 2
Merrillville, IN 46410

Organizations & group practices 4

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": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782259200000",
    "number": "1891856399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1732 S HADLEY RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468041458",
            "telephone_number": "260-438-4905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 E 38TH ST",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469534568",
            "telephone_number": "765-674-3321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAPER",
        "first_name": "MARY",
        "middle_name": "ROSE",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34004314A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000324983",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200002660",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, IN

Sources for this page

Verify at the official NPI Registry.