Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Miss. Mary Mims

Individual provider Clinical Social Worker · NPI 1174989016

Miss. Mary Mims is a Clinical Social Worker in Homewood, Illinois. Qualified in 2002, 24 years ago. Practices with Sondermind Provider Network LLC, a 1,258-clinician group and offers telehealth. Licensed in Illinois and Indiana.

Years since qualifying
24
Licensed in
IL, IN
In the registry since
2016
Specialties on file
2
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

1051 185th St
Homewood, IL 60430-3509
Phone: (708) 903-7689
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 34006323A (IN)
Clinical Social Worker Taxonomy 1041C0700X · Licence 149022074 (IL)

Record details

NPI number1174989016
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJanuary 7, 2016
Last updated in NPPESMay 11, 2020
Certification dateMay 11, 2020
Mailing address1051 185th St, Homewood, IL 60430-3509

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2002 (24 years in practice)
Group practice Sondermind Provider Network Llc — 1258 clinicians
Accepts Medicare assignment Not indicated
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Homewood