Individual provider Active NPI

Mary B Chamberlain, LCSW

  • Clinical Social Worker
  • Monterey, CA
National Provider Identifier
1669482402
Registry record updated Jul 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS20470 Issued in CA
Practice address
23625 Holman Hwy
Monterey, CA 93940-5902
Phone
(831) 624-5311
Fax
(831) 625-4948
NPI assigned
Aug 8, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X LCS20470 CA
Clinical Social Worker 1041C0700X LCS20470 CA Primary

Addresses

Primary practice location

23625 Holman Hwy
Monterey, CA 93940-5902

Mailing address

PO Box HH
Business Development & Contracting
Monterey, CA 93942
Phone (831) 622-2716

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
20470CAMDAddiction (Substance Use Disorder) Counselor
LCS20470CAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Community Hospital of the Monterey Peninsula Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404259200000",
    "number": "1669482402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX HH",
            "address_2": "BUSINESS DEVELOPMENT & CONTRACTING",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "93942",
            "telephone_number": "831-622-2716",
            "fax_number": "831-625-4764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23625 HOLMAN HWY",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939405902",
            "telephone_number": "831-624-5311",
            "fax_number": "831-625-4948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMBERLAIN",
        "first_name": "MARY",
        "middle_name": "B",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2014-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "LCS20470",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS20470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2014; 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.