Active NPI
Chappell Fain Marmon, MSW, LCSW
- Clinical Social Worker
- Boulder, CO
National Provider Identifier
1346454188
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 1303
- Practice address
- 1120 Alpine Ave. Ste. E
Boulder, CO 80304 - Phone
- (303) 437-4158
- NPI assigned
- May 10, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | |||
| Clinical Social Worker | 1041C0700X | 1303 | CO | Primary |
Addresses
Primary practice location
1120 Alpine Ave. Ste. E
Boulder, CO 80304
Mailing address
4019 Wonderland Hill Ave.
Boulder, CO 80304
Phone (303) 437-4158
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1303 | CO | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1335225600000",
"number": "1346454188",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4019 WONDERLAND HILL AVE.",
"city": "BOULDER",
"state": "CO",
"postal_code": "80304",
"telephone_number": "303-437-4158"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1120 ALPINE AVE. STE. E",
"city": "BOULDER",
"state": "CO",
"postal_code": "80304",
"telephone_number": "303-437-4158"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARMON",
"first_name": "CHAPPELL",
"middle_name": "FAIN",
"name_prefix": "Mrs.",
"credential": "MSW, LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-10",
"last_updated": "2012-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CO",
"license": "1303",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boulder, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.