Organization Active NPI

CLB Associates

  • Clinical Social Worker
  • Santa Rosa, CA
National Provider Identifier
1013066489
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW5501 Issued in CA
Legal business name
CLB ASSOCIATES
Practice address
400 W 3Rd St
D-250
Santa Rosa, CA 95401-7601
Phone
(707) 566-7571
NPI assigned
Jan 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Lynn Blumenthal
Title
Manager
Phone
(707) 566-7571

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X CSW5501 CA Primary

Addresses

Primary practice location

400 W 3Rd St
D-250
Santa Rosa, CA 95401-7601

Mailing address

400 W 3Rd St
D-250
Santa Rosa, CA 95401-7601
Phone (707) 566-7571

Other identifiers 1

IdentifierTypeStateIssuer
CSW055010MedicaidCA

National Provider Directory

National Provider Directory

Locations

400 W 3rd St
#D250
Santa Rosa, CA 95401
Phone (707) 566-7571

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013066489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W 3RD ST",
            "address_2": "D-250",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954017601",
            "telephone_number": "707-566-7571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W 3RD ST",
            "address_2": "D-250",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954017601",
            "telephone_number": "707-566-7571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLB ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BLUMENTHAL",
        "authorized_official_first_name": "LYNN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "707-566-7571",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "CSW5501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CSW055010",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.