MARY ROSE LCSW, LLC
NPI 1083399869
Clinic/Center - Mental Health (Including Community Mental Health Center) in Fort Wayne, IN
About Mary Rose Lcsw, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MARY ROSE LCSW, LLC (NPI 1083399869) is a healthcare organization registered as a mental health (including community mental health center) in Fort Wayne, Indiana and active in the NPI registry since June 2023. The organization lists Mary Rose Draper, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mary Rose Lcsw, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Mary Rose Lcsw, LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Mary Rose Lcsw, LLC's NPI number?
The NPI number for Mary Rose Lcsw, LLC is 1083399869. It was assigned to this organization in the NPPES registry on June 19, 2023.
Where is Mary Rose Lcsw, LLC located?
Mary Rose Lcsw, LLC is located at 1732 S Hadley Rd, Fort Wayne, IN 46804. The listed phone number is (260) 438-4905.
What is Mary Rose Lcsw, LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.
Is Mary Rose Lcsw, LLC enrolled in Medicare?
Yes. Mary Rose Lcsw, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Mary Rose Lcsw, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Social Worker) reassigns their Medicare billing to Mary Rose Lcsw, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Mary Rose Lcsw, LLC was last updated on May 5, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mary Rose Lcsw, Llc · NPI 1083399869
Mental Health (Including Community Mental Health Center) organization in Fort Wayne, Indiana. Organization record, active in the CMS NPPES registry since June 19, 2023.
## Identity
- **NPI:** 1083399869 (Entity type: Organization)
- **Enumerated:** June 19, 2023
- **Primary specialty:** Clinic/Center - Mental Health (Including Community Mental Health Center) · taxonomy 261QM0801X
- **Organization subpart:** No
- **Authorized official:** Mary Draper, OWNER
## Practice location
- **Address:** 1732 S HADLEY RD, Fort Wayne, IN 46804-1458
- **Phone:** (260) 438-4905
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Clinical Social Worker) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 5, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1083399869) · Data from the CMS NPPES public registry.