Individual provider Active NPI

Marsha C Mayo, LCSW

  • Clinical Social Worker
  • Virginia Beach, VA
National Provider Identifier
1043650476
Registry record updated Jun 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904008276 Issued in VA
Practice address
2608 Pender Dr
Virginia Beach, VA 23456-3561
Phone
(757) 646-2301
NPI assigned
Jun 29, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904008276 VA Primary

Addresses

Primary practice location

2608 Pender Dr
Virginia Beach, VA 23456-3561

Mailing address

2608 Pender Dr
Virginia Beach, VA 23456-3561
Phone (757) 646-2301

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)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1372464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372464000000",
    "number": "1043650476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2608 PENDER DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234563561",
            "telephone_number": "757-646-2301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2608 PENDER DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234563561",
            "telephone_number": "757-646-2301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYO",
        "first_name": "MARSHA",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-29",
        "last_updated": "2013-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904008276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.