Individual provider Active NPI

Tamara B Chivers, LCSW

  • Clinical Social Worker
  • Mandeville, LA
National Provider Identifier
1255679601
Registry record updated Jan 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9402 Issued in LA
Practice address
900 Wilkinson St
Mandeville, LA 70448-3533
Phone
(985) 624-4450
NPI assigned
Jan 19, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2013

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 9402 LA Primary

Addresses

Primary practice location

900 Wilkinson St
Mandeville, LA 70448-3533

Mailing address

900 Wilkinson St
Mandeville, LA 70448-3533
Phone (985) 624-4450

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
9402LAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1358553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358553600000",
    "number": "1255679601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 WILKINSON ST",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704483533",
            "telephone_number": "985-624-4450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 WILKINSON ST",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704483533",
            "telephone_number": "985-624-4450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIVERS",
        "first_name": "TAMARA",
        "middle_name": "B",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-19",
        "last_updated": "2013-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "9402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mandeville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2013; 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.