Mary Mims
NPI 1174989016ActiveIndividual· Social Worker, Clinical· Homewood, IL
Social Worker, Clinical with Sondermind Provider Network LLC and 1 other group, practicing in Homewood, Illinois. Enrolled in Medicare as practitioner - clinical social worker and practitioner - clinical social worker.
Overview
| NPI | 1174989016 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | Yes |
| NPI issued | Jan 7, 2016 |
| Last updated in NPPES | May 11, 2020 |
| Certified by provider | May 11, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | 34006323A | IN |
| Social Worker, Clinical | 1041C0700X | 149022074 | IL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Social Worker (IL); Practitioner - Clinical Social Worker (IN) |
|---|
Education and affiliations
| Graduation year | 2002 |
|---|---|
| Medicare specialty | Clinical Social Worker |
| Telehealth | Offers telehealth |
Medical groups
- Sondermind Provider Network LLCColumbus, OH · 1,339 clinicians
- Sondermind PCDurham, NC · 68 clinicians
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