Carl Ann Rei P. Bolano, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW129353 Issued in CA

Practice address

520 S la Fayette Park PL FL 3
Los Angeles, CA 90057-1607

Phone

(213) 252-2100

NPI assigned

Sep 10, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Special Service for Groups IncGroup PAC ID 2769396886, 61 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Special Service for Groups, Inc.

  • Voluntary or Charitable Agency
  • Los Angeles, CA
  • NPI 1952442949
  Medicare reassignment Care Compare group NPD
• Special Service for Groups, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Los Angeles, CA
  • NPI 1811028863
  NPD
• Special Service for Groups, Inc.

  • Adolescent and Children Mental Health Clinic/Center
  • Los Angeles, CA
  • NPI 1982735932
  NPD

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

{
    "created_epoch": "1599696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1053926626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 S LA FAYETTE PARK PL FL 3",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900571607",
            "telephone_number": "213-252-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S LA FAYETTE PARK PL FL 3",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900571607",
            "telephone_number": "213-252-2100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 S Grand Ave Ste 600",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900153068",
            "country_code": "US",
            "telephone_number": "213-742-6250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLANO",
        "first_name": "CARL ANN REI",
        "middle_name": "P.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-10",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ACSW104971",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW129353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hans-Peter Boksberger, MD
• Mariam Boktor
• Robert Key Bolan, M.D.
• Julia Lindsay Boland, MD
• Thomas Boland
• Evelyn Bolanos Rosales
• Cheyenne Bolanos
• Joe Anthony Bolanos
• Bold Recovery, Inc.
• Felicia D. Bolden

• Clinical Social Worker in Los Angeles, CA
• Providers in Los Angeles, 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 Apr 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.