Active NPI
Roberto Chong, LICSW
- Clinical Social Worker
- Lawrence, MA
National Provider Identifier
1922145572
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 104557
- Practice address
- 599 Canal St
4TH Floor East
Lawrence, MA 01840-1244 - Phone
- (978) 857-1553
- Fax
- (978) 346-8853
- NPI assigned
- Jan 31, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 104557 | MA | Primary |
Addresses
Primary practice location
599 Canal St
4TH Floor East
Lawrence, MA 01840-1244
Mailing address
599 Canal St
4TH Floor East
Lawrence, MA 01840-1244
Phone (978) 857-1553
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 104557 | MA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1922145572",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "599 CANAL ST",
"address_2": "4TH FLOOR EAST",
"city": "LAWRENCE",
"state": "MA",
"postal_code": "018401244",
"telephone_number": "978-857-1553",
"fax_number": "978-346-8853"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "599 CANAL ST",
"address_2": "4TH FLOOR EAST",
"city": "LAWRENCE",
"state": "MA",
"postal_code": "018401244",
"telephone_number": "978-857-1553",
"fax_number": "978-346-8853"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHONG",
"first_name": "ROBERTO",
"name_prefix": "Mr.",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "104557",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lawrence, MA
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.