Individual provider Active NPI

Monica Wright Wisco, LICSW

  • Clinical Social Worker
  • Chatsworth, CA
National Provider Identifier
1023212701
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1032025 Issued in MA
Practice address
10115 Brooke Ave
Chatsworth, CA 91311-2806
Phone
(818) 739-9058
NPI assigned
Jun 14, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1032025 MA Primary

Addresses

Primary practice location

10115 Brooke Ave
Chatsworth, CA 91311-2806

Mailing address

10115 Brooke Ave
Chatsworth, CA 91311-2806
Phone (818) 739-9058

Other names 1

  • Monica Wright Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20050815000428 MA Practitioner - Clinical Social Worker 3577593144 Practice locations: Danvers, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

150 A Andover St
Suite 11a
Danvers, MA 01923-5316
Phone (310) 729-6709

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1032025MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cagway Health and Wellness LLC PastSince May 1, 2024 Accepting new patients
Sarah McKenzie LMHC LLC Past Accepting new patients

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": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023212701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10115 BROOKE AVE",
            "city": "CHATSWORTH",
            "state": "CA",
            "postal_code": "913112806",
            "telephone_number": "818-739-9058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10115 BROOKE AVE",
            "city": "CHATSWORTH",
            "state": "CA",
            "postal_code": "913112806",
            "telephone_number": "818-739-9058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISCO",
        "first_name": "MONICA",
        "middle_name": "WRIGHT",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1032025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MONICA",
            "last_name": "WRIGHT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chatsworth, CA

Sources for this page

Verify at the official NPI Registry.