Individual provider Active NPI

Michael Hannant

  • Clinical Social Worker
  • Arcadia, CA
National Provider Identifier
1053560060
Registry record updated Feb 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
70167 Issued in CA
Practice address
330 E Live Oak Ave
Arcadia, CA 91006-5617
Phone
(626) 254-1400
NPI assigned
Sep 15, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2021

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 70167 CA Primary
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

330 E Live Oak Ave
Arcadia, CA 91006-5617

Mailing address

11080 W Olympic Blvd
Los Angeles, CA 90064-1937

Other practice location 1

11080 W Olympic Blvd
Los Angeles, CA 90064-1937
Phone (310) 966-6660

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
I20170404001604 CA Practitioner - Clinical Social Worker 1052697182 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Los Angeles County Department of Mental HealthGroup PAC ID 7416869896, 294 clinicians

Practice addresses (Care Compare)

330 E Live Oak Ave
Arcadia MHS
Arcadia, CA 91006-5617
Phone (626) 821-5858

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
70167CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles County Department of Mental Health CurrentSince Feb 25, 2017 Accepting new patients
Los Angeles County Department of Mental Health Current Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Feb 25, 2017 Accepting new patients

Locations

330 E Live Oak Ave
Arcadia, CA 91006
Phone (626) 254-1400

5321 Via Marisol
Los Angeles, CA 90042
Phone (323) 474-6393

510 S Vermont Ave
Fl 19
Los Angeles, CA 90020
Phone (213) 480-3416

11080 W Olympic Blvd
Fl 1
Los Angeles, CA 90064
Phone (310) 966-6610

11080 W Olympic Blvd
Los Angeles, CA 90064
Phone (310) 966-6500

Organizations & group practices 3

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": "1221436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614211200000",
    "number": "1053560060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11080 W OLYMPIC BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900641937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 E LIVE OAK AVE",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910065617",
            "telephone_number": "626-254-1400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11080 W Olympic Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900641937",
            "country_code": "US",
            "telephone_number": "310-966-6660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANNANT",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-15",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "70167",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arcadia, CA

Sources for this page

Verify at the official NPI Registry.