Individual provider Active NPI

Maryann Slack

  • Social Worker
  • Council Bluffs, IA
National Provider Identifier
1932090842
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
133678 Issued in IA
Practice address
902 S 6TH St
Council Bluffs, IA 51501-6441
Phone
(712) 325-1990
NPI assigned
Jul 10, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 133678 IA Primary

Addresses

Primary practice location

902 S 6TH St
Council Bluffs, IA 51501-6441

Mailing address

902 S 6TH St
Council Bluffs, IA 51501-6441
Phone (712) 325-1990

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20250826000574 IA Practitioner - Clinical Social Worker 5991205759 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

902 S 6TH St
Council Bluffs, IA 51501-6441

9425 Delegates Row
Indianapolis, IN 46240-3805

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
All Care Health Center CurrentSince Jul 13, 2025 Accepting new patients
All Care Health Center CurrentSince Jul 13, 2025 Accepting new patients

Locations

902 S 6th St
Rm A
Council Bluffs, IA 51501

902 S 6th St
Council Bluffs, IA 51501
Phone (712) 256-6583

Interoperability endpoints

  • FHIR API: https://webprd.ochin.org/prd-fhir/allcarehealthcenter/api/FHIR/R4

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": "1752105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1932090842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 S 6TH ST",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515016441",
            "telephone_number": "712-325-1990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 S 6TH ST",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515016441",
            "telephone_number": "712-325-1990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLACK",
        "first_name": "MARYANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-10",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IA",
            "license": "133678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Council Bluffs, IA

Sources for this page

Verify at the official NPI Registry.