Active NPI
Bea Ivory-Chambers, LMFT
- Mental Health Counselor
- San Rafael, CA
National Provider Identifier
1851830483
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MFT 40729
- Practice address
- 1330 Lincoln Ave Ste 202B
San Rafael, CA 94901-2142 - Phone
- (415) 233-2333
- NPI assigned
- Feb 15, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MFT 40729 | CA | Primary |
Addresses
Primary practice location
1330 Lincoln Ave Ste 202B
San Rafael, CA 94901-2142
Mailing address
1330 Lincoln Ave Ste 202B
San Rafael, CA 94901-2142
Phone (415) 233-2333
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jan 9, 2024 through Jan 9, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFT 40729 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1487116800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487116800000",
"number": "1851830483",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1330 LINCOLN AVE STE 202B",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949012142",
"telephone_number": "415-233-2333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1330 LINCOLN AVE STE 202B",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949012142",
"telephone_number": "415-233-2333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IVORY-CHAMBERS",
"first_name": "BEA",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-02-15",
"last_updated": "2017-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "MFT 40729",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Rafael, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.