Individual provider Active NPI

Carmen Denice McClain, LCSW

  • Clinical Social Worker
  • Palmdale, CA
National Provider Identifier
1053772897
Registry record updated Aug 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW102755 Issued in CA
Practice address
1529 E Palmdale Blvd Ste 150
Palmdale, CA 93550-2038
Phone
(661) 575-1800
NPI assigned
Mar 7, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2021

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 83585ACSW CA
Clinical Social Worker 1041C0700X LCSW102755 CA Primary

Addresses

Primary practice location

1529 E Palmdale Blvd Ste 150
Palmdale, CA 93550-2038

Mailing address

1529 E Palmdale Blvd Ste 150
Palmdale, CA 93550-2038
Phone (661) 575-1800

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
I20210923003678 CA Practitioner - Clinical Social Worker 3678970258 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
83585ACSWCAMDMental Health Counselor
LCSW102755CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles County Department of Mental Health Current Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Jul 27, 2021 Accepting new patients
Sud Specialty Group - Ca Clinical CurrentSince Aug 1, 2025 Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Jul 27, 2021 Accepting new patients

Locations

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

2260 E Palmdale Blvd
Ste J
Palmdale, CA 93550
Phone (661) 575-1800

1529 E Palmdale Blvd
Ste 150
Palmdale, CA 93550
Phone (661) 575-1800

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

4633 Old Ironsides Dr
Ste 304
Santa Clara, CA 95054
Phone (501) 271-9428

520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295

Organizations & group practices 4

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": "1457308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628208000000",
    "number": "1053772897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1529 E PALMDALE BLVD STE 150",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935502038",
            "telephone_number": "661-575-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1529 E PALMDALE BLVD STE 150",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935502038",
            "telephone_number": "661-575-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLAIN",
        "first_name": "CARMEN",
        "middle_name": "DENICE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-07",
        "last_updated": "2021-08-06",
        "certification_date": "2021-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "83585ACSW",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW102755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmdale, CA

Sources for this page

Verify at the official NPI Registry.