Active NPI
Mary Ellen Warren, LCSW
- Clinical Social Worker
- Wilmington, DE
National Provider Identifier
1992818454
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- Q1-0000753
- Practice address
- 2601 W 4TH St
Wilmington, DE 19805-3309 - Phone
- (302) 656-0651
- Fax
- (302) 654-6432
- NPI assigned
- Aug 17, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Q1-0000753 | DE | Primary |
Addresses
Primary practice location
2601 W 4TH St
Wilmington, DE 19805-3309
Mailing address
102 Humpsman Dr
Dover, DE 19904-1446
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1000025873 | Medicaid | DE |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| Q1-0000753 | DE | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1992818454",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "102 HUMPSMAN DR",
"city": "DOVER",
"state": "DE",
"postal_code": "199041446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2601 W 4TH ST",
"city": "WILMINGTON",
"state": "DE",
"postal_code": "198053309",
"telephone_number": "302-656-0651",
"fax_number": "302-654-6432"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WARREN",
"first_name": "MARY",
"middle_name": "ELLEN",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "DE",
"license": "Q1-0000753",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1000025873",
"state": "DE"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Wilmington, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.