Individual provider Active NPI

Mary McManus, LCSW

  • Clinical Social Worker
  • Laguna Hills, CA
National Provider Identifier
1053776989
Registry record updated Jun 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS14039 Issued in CA
Practice address
23421 S Pointe Dr
#130
Laguna Hills, CA 92653-1553
Phone
(949) 376-1786
NPI assigned
Dec 18, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCS14039 CA Primary

Addresses

Primary practice location

23421 S Pointe Dr
#130
Laguna Hills, CA 92653-1553

Mailing address

23421 S Pointe Dr Ste 130
Laguna Hills, CA 92653-1554
Phone (949) 376-1786

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
I20200423003548 CA Practitioner - Clinical Social Worker 6608206180 Practice locations: Laguna Hills, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

23421 S Pointe Dr
Suite 130
Laguna Hills, CA 92653-1554
Phone (949) 376-1786

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS14039CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Linda Robertson, Marriage & Family Therapist, Inc. Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1450396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467244800000",
    "number": "1053776989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23421 S POINTE DR STE 130",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926531554",
            "telephone_number": "949-376-1786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23421 S POINTE DR",
            "address_2": "#130",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926531553",
            "telephone_number": "949-376-1786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMANUS",
        "first_name": "MARY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-18",
        "last_updated": "2016-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS14039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Hills, CA

Sources for this page

Verify at the official NPI Registry.