Individual provider Active NPI

James Maris McClenon, MSW

  • Clinical Social Worker
  • Chesapeake, VA
National Provider Identifier
1205083722
Registry record updated Aug 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904006938 Issued in VA
Practice address
216 Robert St
Chesapeake, VA 23322-4025
Phone
(757) 482-7126
NPI assigned
Aug 27, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2008

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 0904006938 VA Primary

Addresses

Primary practice location

216 Robert St
Chesapeake, VA 23322-4025

Mailing address

216 Robert St
Chesapeake, VA 23322-4025
Phone (757) 482-7126

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904006938VAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1219795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219795200000",
    "number": "1205083722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 ROBERT ST",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233224025",
            "telephone_number": "757-482-7126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 ROBERT ST",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233224025",
            "telephone_number": "757-482-7126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLENON",
        "first_name": "JAMES",
        "middle_name": "MARIS",
        "name_prefix": "Dr.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-27",
        "last_updated": "2008-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904006938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2008; 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.