Individual provider Active NPI

Christa Chapman Mente, LICSW

  • Clinical Social Worker
  • Omaha, NE
National Provider Identifier
1952691842
Registry record updated Dec 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
116103 Issued in MA
Practice address
6705 Brookridge Dr
Omaha, NE 68137-4300
Phone
(978) 578-6815
NPI assigned
Apr 12, 2011
Last updated
Dec 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 29084 MD
Clinical Social Worker 1041C0700X 116103 MA Primary

Addresses

Primary practice location

6705 Brookridge Dr
Omaha, NE 68137-4300

Mailing address

6705 Brookridge Dr
Omaha, NE 68137-4300
Phone (978) 578-6815

Other practice location 1

29 Summer St Unit 16
Ipswich, MA 01938-2282
Phone (978) 578-6815

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

LicenseStateTypeSpecialty
29084MDMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1302566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703116800000",
    "number": "1952691842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6705 BROOKRIDGE DR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681374300",
            "telephone_number": "978-578-6815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6705 BROOKRIDGE DR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681374300",
            "telephone_number": "978-578-6815"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "29 Summer St Unit 16",
            "address_purpose": "LOCATION",
            "city": "Ipswich",
            "state": "MA",
            "postal_code": "019382282",
            "country_code": "US",
            "telephone_number": "978-578-6815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENTE",
        "first_name": "CHRISTA",
        "middle_name": "CHAPMAN",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-12",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "29084",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "116103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2023; 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.