Active NPI
Cynthia Maria Marzette, LCSW
- Clinical Social Worker
- Antioch, IL
National Provider Identifier
1962520601
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149.015582
- Practice address
- 800 Main St Ste 210
Antioch, IL 60002-1578 - Phone
- (847) 903-5604
- Fax
- (847) 867-7924
- NPI assigned
- Mar 27, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 4834-C | AR | |
| Clinical Social Worker | 1041C0700X | 149.015582 | IL | Primary |
Addresses
Primary practice location
800 Main St Ste 210
Antioch, IL 60002-1578
Mailing address
1 N Oplaine Rd Unit 8621
Gurnee, IL 60031-0869
Phone (479) 313-4794
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4834-C | AR | MD | Clinical Social Worker |
| 149.015582 | IL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Home Psych Services, P.C. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Clinical Psychologist
- Hinsdale, IL
- NPI 1174821946
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600041600000",
"number": "1962520601",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 N OPLAINE RD UNIT 8621",
"city": "GURNEE",
"state": "IL",
"postal_code": "600310869",
"telephone_number": "479-313-4794",
"fax_number": "847-672-8714"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 MAIN ST STE 210",
"city": "ANTIOCH",
"state": "IL",
"postal_code": "600021578",
"telephone_number": "847-903-5604",
"fax_number": "847-867-7924"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARZETTE",
"first_name": "CYNTHIA",
"middle_name": "MARIA",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-27",
"last_updated": "2020-09-14",
"certification_date": "2020-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "AR",
"license": "4834-C",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149.015582",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Antioch, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.