Individual provider Active NPI

Patricia Kelly Michals, MFT, LCSW

  • Clinical Social Worker
  • Del Mar, CA
National Provider Identifier
1033362520
Registry record updated Oct 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3438 Issued in CA
Practice address
3790 Via de la Valle
Suite 113 E
Del Mar, CA 92014-4247
Phone
(858) 755-5687
Fax
(858) 792-6384
NPI assigned
Oct 28, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 3438 CA Primary
Marriage & Family Therapist 106H00000X 5362 CA

Addresses

Primary practice location

3790 Via de la Valle
Suite 113 E
Del Mar, CA 92014-4247

Mailing address

3790 Via de la Valle
Suite 113 E
Del Mar, CA 92014-4247
Phone (858) 755-5687

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3438CAMDClinical Social Worker
5362CAMDWomen's Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225152000000",
    "number": "1033362520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3790 VIA DE LA VALLE",
            "address_2": "SUITE 113 E",
            "city": "DEL MAR",
            "state": "CA",
            "postal_code": "920144247",
            "telephone_number": "858-755-5687",
            "fax_number": "858-792-6384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3790 VIA DE LA VALLE",
            "address_2": "SUITE 113 E",
            "city": "DEL MAR",
            "state": "CA",
            "postal_code": "920144247",
            "telephone_number": "858-755-5687",
            "fax_number": "858-792-6384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHALS",
        "first_name": "PATRICIA",
        "middle_name": "KELLY",
        "name_prefix": "Ms.",
        "credential": "MFT, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-28",
        "last_updated": "2008-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "3438",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "5362",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Del Mar, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2008; 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.