Individual provider Active NPI

Chigolum Anene

  • Clinical Social Worker
  • Lancaster, CA
National Provider Identifier
1043864515
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
118105 Issued in CA
Practice address
300 E Avenue K6
Lancaster, CA 93535-4504
Phone
(661) 471-1001
NPI assigned
Aug 1, 2019
Last updated
May 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X 118105 CA Primary

Addresses

Primary practice location

300 E Avenue K6
Lancaster, CA 93535-4504

Mailing address

300 E Avenue K6
Lancaster, CA 93535-4504

Other identifiers 1

IdentifierTypeStateIssuer
95-2633765MedicaidCA

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
I20260202001885 CA Practitioner - Clinical Social Worker 0648758557 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
118105CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PC Mental Health CurrentSince Dec 23, 2025 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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1564617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1043864515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E AVENUE K6",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935354504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E AVENUE K6",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935354504",
            "telephone_number": "661-471-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANENE",
        "first_name": "CHIGOLUM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-01",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "118105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95-2633765",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

Verify at the official NPI Registry.