Beth Ann Charbonneau, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

12096 Issued in MD

Practice address

7307 Baltimore Ave
Suite 208
College Park, MD 20740-3231

Phone

(301) 345-1919

Fax

(301) 345-5779

NPI assigned

Jul 8, 2006

Last updated

Oct 13, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 1, 2018 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318464000000",
    "number": "1861425407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9718 51ST PL",
            "city": "COLLEGE PARK",
            "state": "MD",
            "postal_code": "207401502",
            "telephone_number": "240-353-3956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7307 BALTIMORE AVE",
            "address_2": "SUITE 208",
            "city": "COLLEGE PARK",
            "state": "MD",
            "postal_code": "207403231",
            "telephone_number": "301-345-1919",
            "fax_number": "301-345-5779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARBONNEAU",
        "first_name": "BETH",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-08",
        "last_updated": "2011-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "12096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "404835100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Conrad Carter, DPT
• Stephanie Marie Cathell, OD
• Adia Chambers
• Ngekwi Chanchi Marilyn
• Prisco Chapajong
• Matthew Robert Charvat, A.T.,C.
• Awa Cheika
• Eddy Chen
• Yangyi Chen, LAC
• Jiyon Cheng, O.D.

• Clinical Social Worker in College Park, MD
• Providers in College Park, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2011; 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.

Verify at the official NPI Registry.