Individual provider Active NPI

Melissa Cheree Marrs, LCSW

  • Clinical Social Worker
  • Homeland, CA
National Provider Identifier
1285828285
Registry record updated Aug 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
29402 Issued in CA
Practice address
25866 Juniper Flats Rd
Homeland, CA 92548-9324
Phone
(503) 701-7378
NPI assigned
Sep 2, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X L3330 OR
Clinical Social Worker 1041C0700X 29402 CA Primary

Addresses

Primary practice location

25866 Juniper Flats Rd
Homeland, CA 92548-9324

Mailing address

25866 Juniper Flats Rd
Homeland, CA 92548-9324
Phone (503) 701-7378

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
29402CAMDClinical Social Worker
L3330ORMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1188691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597708800000",
    "number": "1285828285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25866 JUNIPER FLATS RD",
            "city": "HOMELAND",
            "state": "CA",
            "postal_code": "925489324",
            "telephone_number": "503-701-7378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25866 JUNIPER FLATS RD",
            "city": "HOMELAND",
            "state": "CA",
            "postal_code": "925489324",
            "telephone_number": "503-701-7378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARRS",
        "first_name": "MELISSA",
        "middle_name": "CHEREE",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-02",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L3330",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "29402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homeland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2020; 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.