Individual provider Active NPI

Jane Keisha Tambree, LCSW-C

  • Clinical Social Worker
  • Baltimore, MD
National Provider Identifier
1073764130
Registry record updated Dec 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
05716 Issued in MD
Practice address
4502 Schenley Rd Ste 100a
Baltimore, MD 21210
Phone
(240) 706-7620
NPI assigned
Oct 8, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2018

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 05716 MD Primary

Addresses

Primary practice location

4502 Schenley Rd Ste 100a
Baltimore, MD 21210

Mailing address

4502 Schenley Rd Ste 100a
Baltimore, MD 21210-2524
Phone (240) 706-7620

Other practice location 1

3243 Eastern Ave
Baltimore, MD 21224-4013
Phone (410) 276-0153

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
05716MDMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1223424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545782400000",
    "number": "1073764130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4502 SCHENLEY RD STE 100A",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212102524",
            "telephone_number": "240-706-7620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4502 SCHENLEY RD STE 100A",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21210",
            "telephone_number": "240-706-7620"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3243 Eastern Ave",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212244013",
            "country_code": "US",
            "telephone_number": "410-276-0153",
            "fax_number": "410-732-1062",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAMBREE",
        "first_name": "JANE",
        "middle_name": "KEISHA",
        "name_prefix": "Ms.",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-08",
        "last_updated": "2018-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "05716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2018; 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.