Individual provider Active NPI

Mary Lee Eames, LCSW

  • Clinical Social Worker
  • Long Beach, CA
National Provider Identifier
1184473050
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
118806 Issued in CA
Practice address
3910 Hathaway Ave Apt 956
Long Beach, CA 90815-5127
Phone
(562) 552-4202
NPI assigned
May 14, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2024

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 118806 CA Primary

Addresses

Primary practice location

3910 Hathaway Ave Apt 956
Long Beach, CA 90815-5127

Mailing address

PO Box 91794
Long Beach, CA 90809-1794
Phone (562) 552-4202

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240909002006 CA Practitioner - Clinical Social Worker 1759821416 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Blue Moon Senior Counseling of California LLCGroup PAC ID 9335360981, 79 clinicians

Practice addresses (Care Compare)

Palm Springs, CA 92264
Phone (855) 241-7160

39905 Via Scena
Unit 218
Palm Desert, CA 92260-1827
Phone (855) 241-7160

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Moon Senior Counseling of California LLC Clinical CurrentSince Jul 10, 2024 Accepting new patients

Locations

10204 Bode St
Ste B
Plainfield, IL 60585
Phone (630) 229-6462

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1715644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1184473050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 91794",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908091794",
            "telephone_number": "562-552-4202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3910 HATHAWAY AVE APT 956",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908155127",
            "telephone_number": "562-552-4202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EAMES",
        "first_name": "MARY",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-14",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "118806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.