Individual provider Active NPI

Carolyn Lee Chambers

  • Social Worker
  • Detroit, MI
National Provider Identifier
1043731292
Registry record updated Jun 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801101113 Issued in MI
Practice address
2051 W Grand Blvd
Detroit, MI 48208-1105
Phone
(313) 961-3200
NPI assigned
Jun 28, 2017
Last updated
Jun 28, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801101113 MI Primary

Addresses

Primary practice location

2051 W Grand Blvd
Detroit, MI 48208-1105

Mailing address

2051 W Grand Blvd
Detroit, MI 48208-1105
Phone (313) 961-3200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191210002714 MI Practitioner - Clinical Social Worker 3577996214 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Wayne State University School of Medicine
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Macomb Family Services IncGroup PAC ID 5193700888, 19 clinicians

Practice addresses (Care Compare)

35000 Division Rd
Suite 2
Richmond, MI 48062-1566
Phone (586) 727-5529

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801101113MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Macomb Family Services, Inc. CurrentSince Oct 26, 2019 Accepting new patients
Macomb Family Services, Inc Past Accepting new patients

Locations

36975 Utica Rd
Ste 103
Clinton Twp, MI 48036
Phone (586) 226-3440

36975 Utica Rd
Ste 104
Clinton Twp, MI 48036
Phone (586) 226-3440

35000 Division Rd
Ste 2
Richmond, MI 48062
Phone (586) 727-5529

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/macombfamily/r4/

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1498608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498608000000",
    "number": "1043731292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2051 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482081105",
            "telephone_number": "313-961-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2051 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482081105",
            "telephone_number": "313-961-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMBERS",
        "first_name": "CAROLYN",
        "middle_name": "LEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-28",
        "last_updated": "2017-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801101113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.