Individual provider Active NPI

Mary Arnold, LCSW

  • Clinical Social Worker
  • Homestead AFB, FL
National Provider Identifier
1689066847
Registry record updated Feb 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW23122 Issued in CA
Practice address
482D Medical Squadron
12749 Elmendorf St BLDG 347
Homestead AFB, FL 33039-0001
Phone
(786) 415-7615
NPI assigned
Feb 25, 2015
Last updated
Feb 25, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 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 LCSW23122 CA Primary

Addresses

Primary practice location

482D Medical Squadron
12749 Elmendorf St BLDG 347
Homestead AFB, FL 33039-0001

Mailing address

482D Medical Squadron
12749 Elmendorf St BLDG 347
Homestead AFB, FL 33039-0001
Phone (786) 415-7615

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
LCSW23122CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1424822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424822400000",
    "number": "1689066847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "482D MEDICAL SQUADRON",
            "address_2": "12749 ELMENDORF ST BLDG 347",
            "city": "HOMESTEAD AFB",
            "state": "FL",
            "postal_code": "330390001",
            "telephone_number": "786-415-7615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "482D MEDICAL SQUADRON",
            "address_2": "12749 ELMENDORF ST BLDG 347",
            "city": "HOMESTEAD AFB",
            "state": "FL",
            "postal_code": "330390001",
            "telephone_number": "786-415-7615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARNOLD",
        "first_name": "MARY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-25",
        "last_updated": "2015-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW23122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homestead AFB, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.