Individual provider Active NPI

Marjorie Jean Brody, LCSW

  • Clinical Social Worker
  • Palo Alto, CA
National Provider Identifier
1154443935
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
007331 Issued in CA
Practice address
1636 Edgewood Dr
Palo Alto, CA 94303-2820
Phone
(650) 325-2228
NPI assigned
Apr 4, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 007331 CA Primary

Addresses

Primary practice location

1636 Edgewood Dr
Palo Alto, CA 94303-2820

Mailing address

1636 Edgewood Dr
Palo Alto, CA 94303-2820
Phone (650) 325-2228

Other identifiers 2

IdentifierTypeStateIssuer
ZZZ14330ZOtherCABLUE SHIELD SAINT BARNABU
OS0382OtherMHN

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
007331CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154443935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1636 EDGEWOOD DR",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943032820",
            "telephone_number": "650-325-2228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1636 EDGEWOOD DR",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943032820",
            "telephone_number": "650-325-2228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODY",
        "first_name": "MARJORIE",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "007331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD SAINT BARNABU",
            "identifier": "ZZZ14330Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN",
            "identifier": "OS0382",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.