Individual provider Active NPI

Donna Jean Scarborough, LCSW

  • Clinical Social Worker
  • Ketchikan, AK
National Provider Identifier
1679644322
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
646 Issued in AK
Practice address
3050 5TH Ave
Ketchikan, AK 99901-5773
Phone
(907) 228-6509
Fax
(907) 247-4135
NPI assigned
Nov 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 646 AK Primary

Addresses

Primary practice location

3050 5TH Ave
Ketchikan, AK 99901-5773

Mailing address

PO Box 5323
Ketchikan, AK 99901-0323
Phone (907) 225-1592

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
646AKMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679644322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5323",
            "city": "KETCHIKAN",
            "state": "AK",
            "postal_code": "999010323",
            "telephone_number": "907-225-1592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 5TH AVE",
            "city": "KETCHIKAN",
            "state": "AK",
            "postal_code": "999015773",
            "telephone_number": "907-228-6509",
            "fax_number": "907-247-4135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCARBOROUGH",
        "first_name": "DONNA",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AK",
            "license": "646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ketchikan, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.