Active NPI
Ayat Madi
- Clinical Social Worker
- Long Beach, CA
National Provider Identifier
1003399874
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 102849
- Practice address
- 3939 Atlantic Ave Ste 103
Long Beach, CA 90807-3529 - Phone
- (562) 264-6001
- NPI assigned
- Sep 7, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Clinical Social Worker | 1041C0700X | 102849 | CA | Primary |
Addresses
Primary practice location
3939 Atlantic Ave Ste 103
Long Beach, CA 90807-3529
Mailing address
447 N El Molino Ave
Pasadena, CA 91101-1403
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 |
|---|---|---|---|
| 102849 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628035200000",
"number": "1003399874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "447 N EL MOLINO AVE",
"city": "PASADENA",
"state": "CA",
"postal_code": "911011403"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3939 ATLANTIC AVE STE 103",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908073529",
"telephone_number": "562-264-6001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MADI",
"first_name": "AYAT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-07",
"last_updated": "2021-08-04",
"certification_date": "2021-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "102849",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.