Elyce Darcell Mandich, MSW, LCSW, PPSC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

831141 Issued in CA

Practice address

27215 Nicolas Rd
Temecula, CA 92591-7348

Phone

(951) 401-0533

NPI assigned

May 21, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Elyce Darcell Maxwell Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1590019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590019200000",
    "number": "1013530229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31350 RANCHO VISTA RD",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925926200",
            "telephone_number": "951-401-0533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27215 NICOLAS RD",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925917348",
            "telephone_number": "951-401-0533"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "31350 Rancho Vista Rd",
            "address_purpose": "LOCATION",
            "city": "Temecula",
            "state": "CA",
            "postal_code": "925926200",
            "country_code": "US",
            "telephone_number": "951-401-0533",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANDICH",
        "first_name": "ELYCE",
        "middle_name": "DARCELL",
        "credential": "MSW, LCSW, PPSC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-21",
        "last_updated": "2020-05-21",
        "certification_date": "2020-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "831141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELYCE",
            "last_name": "MAXWELL",
            "middle_name": "DARCELL",
            "credential": "MSW, LCSW, PPSC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Clinical Social Worker in Temecula, CA
• Providers in Temecula, CA by specialty
• Clinical Social Worker in California

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