Individual provider Active NPI

Carolyn Anne Chambers, LPC

  • Professional Counselor
  • Saint Clairsville, OH
National Provider Identifier
1184254450
Registry record updated Dec 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2103720 Issued in OH
Practice address
255 W Main St
Saint Clairsville, OH 43950-1040
Phone
(740) 695-9447
NPI assigned
Jan 24, 2020
Last updated
Dec 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2103720 OH Primary

Addresses

Primary practice location

255 W Main St
Saint Clairsville, OH 43950-1040

Mailing address

30800 Chagrin Blvd
Pepper Pike, OH 44124-5925
Phone (216) 591-0324

Other practice location 1

30800 Chagrin Blvd
Pepper Pike, OH 44124-5925
Phone (216) 591-0324

Other identifiers 1

IdentifierTypeStateIssuer
2877463MedicaidOH

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
2103720OHMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1579824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671580800000",
    "number": "1184254450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30800 CHAGRIN BLVD",
            "city": "PEPPER PIKE",
            "state": "OH",
            "postal_code": "441245925",
            "telephone_number": "216-591-0324",
            "fax_number": "216-591-1243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 W MAIN ST",
            "city": "SAINT CLAIRSVILLE",
            "state": "OH",
            "postal_code": "439501040",
            "telephone_number": "740-695-9447"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30800 Chagrin Blvd",
            "address_purpose": "LOCATION",
            "city": "Pepper Pike",
            "state": "OH",
            "postal_code": "441245925",
            "country_code": "US",
            "telephone_number": "216-591-0324",
            "fax_number": "216-591-1243",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAMBERS",
        "first_name": "CAROLYN",
        "middle_name": "ANNE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-24",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "2103720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2877463",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clairsville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2022; 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.