Mary Okoth, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

132127 Issued in CA

Practice address

804 Pier View Way Ste 211
Oceanside, CA 92054-2863

Phone

(504) 233-9546

NPI assigned

Aug 29, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 1, 2024 through Apr 1, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Deeply Rooted Psychotherapy, LLC

  • Mental Health Counselor
  • North Palm Beach, FL
  • NPI 1801593348

  Clinical

  NPD (past)

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

{
    "created_epoch": "1661731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1033839279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 PIER VIEW WAY STE 211",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920542863",
            "telephone_number": "504-233-9546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 PIER VIEW WAY STE 211",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920542863",
            "telephone_number": "504-233-9546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKOTH",
        "first_name": "MARY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-29",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW20942",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "132127",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "15226",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Odermatt, MD
• Shannen Kelley Odonnell, RBT
• Bismark Youngmin Oh, MD
• Bianca Ruby Ojeda
• Hejira Smith Ojeda, M.S.
• Rachel Kristine Olesen
• Veronica Olivares
• Marlene Olivas-Gradias
• Monique Olivieri
• Krister Olsson

• Clinical Social Worker in Oceanside, CA
• Providers in Oceanside, 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 Aug 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.