Individual provider Active NPI

Kristine Asatryan, LCSW

  • Clinical Social Worker
  • Glendale, CA
National Provider Identifier
1013282151
Registry record updated May 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
93947 Issued in CA
Practice address
1315 E Harvard St Apt C
Glendale, CA 91205-4051
Phone
(818) 395-9796
NPI assigned
Mar 21, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 93947 CA Primary

Addresses

Primary practice location

1315 E Harvard St Apt C
Glendale, CA 91205-4051

Mailing address

1315 E Harvard St Apt C
Glendale, CA 91205-4051
Phone (818) 395-9796

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230201002977 CA Practitioner - Clinical Social Worker 1557733441 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PC Clinical CurrentSince Jan 4, 2023 Accepting new patients
Power of Now Corporation Clinical CurrentSince Jun 15, 2021 Accepting new patients

Locations

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1332288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622419200000",
    "number": "1013282151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 E HARVARD ST APT C",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912054051",
            "telephone_number": "818-395-9796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 E HARVARD ST APT C",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912054051",
            "telephone_number": "818-395-9796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASATRYAN",
        "first_name": "KRISTINE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-21",
        "last_updated": "2021-05-31",
        "certification_date": "2021-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "93947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.