Kembly Astua Mahiri, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCS22591 Issued in CA

Practice address

625 5TH St
Santa Rosa, CA 95404-4428

Phone

(707) 565-4489

NPI assigned

Sep 14, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• County of Sonoma

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Santa Rosa, CA
  • NPI 1306050828
  NPD
• County of Sonoma

  • Adolescent and Children Mental Health Clinic/Center
  • Santa Rosa, CA
  • NPI 1457498636
  NPD
• County of Sonoma

  • Community Health Clinic/Center
  • Cloverdale, CA
  • NPI 1952637027
  NPD

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

{
    "created_epoch": "1536883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536883200000",
    "number": "1245713262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 5TH ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044428",
            "telephone_number": "707-565-4489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 5TH ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044428",
            "telephone_number": "707-565-4489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHIRI",
        "first_name": "KEMBLY",
        "middle_name": "ASTUA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-14",
        "last_updated": "2018-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS22591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bethany Susanne Magnuson
• Maria Rebecca Maguire
• Melody Maguire, RASI
• Allison Michelle Magyar, MSN, APRN, FNP-BC
• Devon Maher
• Ara Mahmoudi, PHARMD, RPH
• Kimberly Ann Mahood, D.M.D., M.S.D.
• Kimberly Mahr
• Lilian Lili Mai
• Mervin Maier, M.F.T

• Clinical Social Worker in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.