Individual provider Active NPI

Kathleen Veronica McCarrick

  • Clinical Social Worker
  • Oceanside, CA
National Provider Identifier
1063014975
Registry record updated Nov 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW96985 Issued in CA
Practice address
315 N Clementine St
Oceanside, CA 92054-2806
Phone
(760) 433-4357
NPI assigned
Nov 15, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X LCSW96985 CA Primary

Addresses

Primary practice location

315 N Clementine St
Oceanside, CA 92054-2806

Mailing address

35865 Shetland HLS E
Fallbrook, CA 92028-6519
Phone (484) 431-7678

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210115001464 CA Practitioner - Clinical Social Worker 4183037948 Reassigns benefits to 1 organization
I20240506000899 PA Practitioner - Clinical Social Worker 4183037948 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW96985CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PC Clinical CurrentSince Apr 11, 2024 Accepting new patients
Grow Healthcare Group PA Clinical CurrentSince Apr 11, 2024 Accepting new patients
Marvin Behavioral Health Ca PC Clinical Past 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

1626 Locust St
Philadelphia, PA 19103
Phone (215) 709-3177

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": "1605398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605398400000",
    "number": "1063014975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35865 SHETLAND HLS E",
            "city": "FALLBROOK",
            "state": "CA",
            "postal_code": "920286519",
            "telephone_number": "484-431-7678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 N CLEMENTINE ST",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920542806",
            "telephone_number": "760-433-4357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCARRICK",
        "first_name": "KATHLEEN",
        "middle_name": "VERONICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-15",
        "last_updated": "2020-11-15",
        "certification_date": "2020-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW96985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, CA

Sources for this page

Verify at the official NPI Registry.