Individual provider Active NPI

Maureen Courtenay Chamberlain, LCSW-C

  • Clinical Social Worker
  • Hagerstown, MD
National Provider Identifier
1407862303
Registry record updated Oct 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
10390 Issued in MD
Practice address
251 E Antietam St
5D
Hagerstown, MD 21740-5724
Phone
(301) 766-7600
Fax
(301) 766-7702
NPI assigned
Jul 31, 2006
Last updated
Oct 21, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2015

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 10390 MD Primary

Addresses

Primary practice location

251 E Antietam St
5D
Hagerstown, MD 21740-5724

Mailing address

11116 Medical Campus Rd 2989
Hagerstown, MD 21742-6710
Phone (301) 766-7600

Other identifiers 4

IdentifierTypeStateIssuer
PHCS9031546OtherMDPHCS
000395600MedicaidMD
614437-01OtherMDBCBS
121724OtherMDJOHN HOPKINS HEALTHCARE

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
10390MDMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445385600000",
    "number": "1407862303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11116 MEDICAL CAMPUS RD 2989",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217426710",
            "telephone_number": "301-766-7600",
            "fax_number": "301-766-7702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 E ANTIETAM ST",
            "address_2": "5D",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217405724",
            "telephone_number": "301-766-7600",
            "fax_number": "301-766-7702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMBERLAIN",
        "first_name": "MAUREEN",
        "middle_name": "COURTENAY",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2015-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "10390",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS",
            "identifier": "PHCS9031546",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000395600",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "614437-01",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN HOPKINS HEALTHCARE",
            "identifier": "121724",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2015; 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.