Marnessa J Bambara, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

09926336 Issued in CO

Practice address

4770 Baseline Rd Ste 200
Boulder, CO 80303-2668

Phone

(720) 893-0842

Fax

(617) 507-1426

NPI assigned

Mar 19, 2015

Last updated

Apr 13, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Marnie Kaiser Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1426723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586736000000",
    "number": "1154715894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4770 BASELINE RD STE 200",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803032668",
            "telephone_number": "720-893-0842",
            "fax_number": "617-507-1426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4770 BASELINE RD STE 200",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803032668",
            "telephone_number": "720-893-0842",
            "fax_number": "617-507-1426"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "148 Wilson Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112378042",
            "country_code": "US",
            "telephone_number": "917-509-4183",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAMBARA",
        "first_name": "MARNESSA",
        "middle_name": "J",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-19",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "087302",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CO",
            "license": "09926336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARNIE",
            "last_name": "KAISER",
            "credential": "LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Winter Ball, PT, DPT
• Sherrie Lynn Ballantine-Talmadge, D.O.
• Carrie Lee Ballas, FNP-C
• Tracy Ann Balthazor, P.T.
• Annie Bamaw
• Jennifer Ban, PTA, CMT
• Anita P Bancroft, RDN
• Polly Banerjee Gallagher
• Moni Banerjee, PA
• Lori Banghart, MA, CCC-SLP

• Social Worker in Boulder, CO
• Providers in Boulder, CO by specialty
• Social Worker in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2020; 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.