| Mari Mortensen Lcsw Pllc | |
|
101 N Marion St Ste 300 Oak Park IL 60301-1023 | |
| (708) 650-4356 | |
| Not Available |
| Full Name | Mari Mortensen Lcsw Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 101 N Marion St Ste 300, Oak Park, Illinois |
| Authorized Official Name and Position | Mari Mortensen (OWNER) |
| Authorized Official Contact | 7086504356 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mari Mortensen Lcsw Pllc 9265 Waterfall Glen Blvd Darien IL 60561-5282 Ph: (708) 650-4356 | Mari Mortensen Lcsw Pllc 101 N Marion St Ste 300 Oak Park IL 60301-1023 Ph: (708) 650-4356 |
| NPI Number | 1780412403 |
|---|---|
| Provider Enumeration Date | 07/24/2024 |
| Last Update Date | 02/27/2025 |
| Certification Date | 02/27/2025 |
| Medicare PECOS PAC ID | 6800333071 |
|---|---|
| Medicare Enrollment ID | O20240806000821 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780412403 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Mari Mortensen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578276770 PECOS PAC ID: 7618414889 Enrollment ID: I20240806000961 |
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