Individual provider Active NPI

Emily Grace Mentin-Chamble, LMSW

  • Clinical Social Worker
  • Jamaica, NY
National Provider Identifier
1689980963
Registry record updated Aug 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
077496 Issued in NY
Practice address
90-37 Parsons Blvd
Jamaica, NY 11432
Phone
(718) 334-6400
Fax
(718) 334-6430
NPI assigned
Aug 25, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2010

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 077496 NY Primary

Addresses

Primary practice location

90-37 Parsons Blvd
Jamaica, NY 11432

Mailing address

79-01 Broadway
Managed Care, D1-01
Elmhurst, NY 11373-1329
Phone (718) 334-1921

Other names 1

  • Mrs. Emily Grace Mentin Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170710001900 MA Practitioner - Clinical Social Worker 8527337344 Practice locations: Amherst, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

441 W St
Amherst, MA 01002-2997
Phone (413) 345-2086

489 Market Hill Rd
Amherst, MA 01002-1244

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
077496NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1282694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282694400000",
    "number": "1689980963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79-01 BROADWAY",
            "address_2": "MANAGED CARE, D1-01",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731329",
            "telephone_number": "718-334-1921",
            "fax_number": "718-334-3432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90-37 PARSONS BLVD",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "11432",
            "telephone_number": "718-334-6400",
            "fax_number": "718-334-6430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENTIN-CHAMBLE",
        "first_name": "EMILY",
        "middle_name": "GRACE",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-25",
        "last_updated": "2010-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "077496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "MENTIN",
            "middle_name": "GRACE",
            "prefix": "MRS.",
            "credential": "LMSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jamaica, NY

Sources for this page

Verify at the official NPI Registry.