Organization Active NPI

Chaparral Counseling, Licensed Clinical Social Worker, PC

  • Clinical Social Worker
  • Oakland, CA
National Provider Identifier
1003576224
Registry record updated Dec 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
CHAPARRAL COUNSELING, LICENSED CLINICAL SOCIAL WORKER, PC
Doing business as
Chaparral Counseling
Practice address
2100 Lakeshore Ave Ste C
Oakland, CA 94606-1188
Phone
(510) 971-0799
NPI assigned
Dec 29, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2021

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

Authorized official

Name
Fiona C. Lundy, LCSW
Title
President
Phone
(510) 971-0799

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

2100 Lakeshore Ave Ste C
Oakland, CA 94606-1188

Mailing address

2100 Lakeshore Ave Ste C
Oakland, CA 94606-1188
Phone (510) 971-0799

Other names 1

  • Chaparral Counseling Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220303001557 CA Part B Supplier - Clinic/Group Practice 5890189039 Receives reassigned benefits from 1 practitioner
Practice locations: Oakland, CA

National Provider Directory

National Provider Directory

Locations

2100 Lakeshore Ave
Ste C
Oakland, CA 94606
Phone (510) 420-1258

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1640736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640736000000",
    "number": "1003576224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 LAKESHORE AVE STE C",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946061188",
            "telephone_number": "510-971-0799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 LAKESHORE AVE STE C",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946061188",
            "telephone_number": "510-971-0799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAPARRAL COUNSELING, LICENSED CLINICAL SOCIAL WORKER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-29",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-29",
        "status": "A",
        "authorized_official_last_name": "LUNDY",
        "authorized_official_first_name": "FIONA C.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "510-971-0799",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chaparral Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.