Active NPI
Eliza Cabot Chamblin, LCSW
- Clinical Social Worker
- Brooklyn, NY
National Provider Identifier
1295285013
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 084804
- Practice address
- 162 W 9TH St
Apartment 2
Brooklyn, NY 11231-3904 - Phone
- (610) 405-6510
- NPI assigned
- Oct 4, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 084804 | NY | Primary |
Addresses
Primary practice location
162 W 9TH St
Apartment 2
Brooklyn, NY 11231-3904
Mailing address
162 W 9TH St
Apartment 2
Brooklyn, NY 11231-3904
Phone (610) 405-6510
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 15, 2024 through Apr 15, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 084804 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1475539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475539200000",
"number": "1295285013",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "162 W 9TH ST",
"address_2": "APARTMENT 2",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112313904",
"telephone_number": "610-405-6510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "162 W 9TH ST",
"address_2": "APARTMENT 2",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112313904",
"telephone_number": "610-405-6510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAMBLIN",
"first_name": "ELIZA",
"middle_name": "CABOT",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-10-04",
"last_updated": "2016-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "084804",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.