Active NPI
Stephanie Coram
- Mental Health Counselor
- San Mateo, CA
National Provider Identifier
1134500069
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- ASW32060
- Practice address
- 225 37TH Ave
3Rd Floor
San Mateo, CA 94403-4324 - Phone
- (650) 573-2541
- NPI assigned
- Jun 16, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | ASW32060 | CA | Primary |
| Clinical Social Worker | 1041C0700X | ASW32060 | CA |
Addresses
Primary practice location
225 37TH Ave
3Rd Floor
San Mateo, CA 94403-4324
Mailing address
225 37TH Ave
3Rd Floor
San Mateo, CA 94403-4324
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
| License | State | Type | Specialty |
|---|---|---|---|
| ASW32060 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1434412800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1434412800000",
"number": "1134500069",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "225 37TH AVE",
"address_2": "3RD FLOOR",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944034324"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "225 37TH AVE",
"address_2": "3RD FLOOR",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944034324",
"telephone_number": "650-573-2541"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORAM",
"first_name": "STEPHANIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-16",
"last_updated": "2015-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "ASW32060",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "ASW32060",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Mateo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.