Individual provider Active NPI

Mary M. Rezac, LCSW

  • Clinical Social Worker
  • Lewes, DE
National Provider Identifier
1962411728
Registry record updated Mar 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
Q1-0000600 Issued in DE
Practice address
30844 Ridge CT
Lewes, DE 19958-5566
Phone
(302) 438-8733
NPI assigned
Aug 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2017

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 Q1-0000600 DE Primary

Addresses

Primary practice location

30844 Ridge CT
Lewes, DE 19958-5566

Mailing address

30844 Ridge CT
Lewes, DE 19958-5566
Phone (302) 345-1919

Other names 1

  • Ms. Marcey Rezac Other name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
Q1-0000600DEMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490140800000",
    "number": "1962411728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30844 RIDGE CT",
            "city": "LEWES",
            "state": "DE",
            "postal_code": "199585566",
            "telephone_number": "302-345-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30844 RIDGE CT",
            "city": "LEWES",
            "state": "DE",
            "postal_code": "199585566",
            "telephone_number": "302-438-8733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REZAC",
        "first_name": "MARY",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-07",
        "last_updated": "2017-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DE",
            "license": "Q1-0000600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARCEY",
            "last_name": "REZAC",
            "prefix": "MS.",
            "credential": "LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lewes, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.