Individual provider Active NPI

Mariana Antonette Peoples, LCSW

  • Clinical Social Worker
  • Klamath Falls, OR
National Provider Identifier
1114437175
Registry record updated Oct 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L4316 Issued in OR
Practice address
211 Arnold Ave Ste 11
Klamath Falls, OR 97603-2106
Phone
(541) 885-6644
NPI assigned
Oct 4, 2017
Last updated
Oct 4, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2017

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 L4316 OR Primary

Addresses

Primary practice location

211 Arnold Ave Ste 11
Klamath Falls, OR 97603-2106

Mailing address

4306 Anderson Ave
Klamath Falls, OR 97603-8464
Phone (541) 885-6644

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
L4316ORMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1507075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507075200000",
    "number": "1114437175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4306 ANDERSON AVE",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976038464",
            "telephone_number": "541-885-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 ARNOLD AVE STE 11",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976032106",
            "telephone_number": "541-885-6644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEOPLES",
        "first_name": "MARIANA",
        "middle_name": "ANTONETTE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-04",
        "last_updated": "2017-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L4316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Klamath Falls, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2017; 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.