Active NPI
George Wallace Hearne, LCSW
- Clinical Social Worker
- Sacramento, CA
National Provider Identifier
1063533842
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS 13333
- Practice address
- 3517 Marconi Ave
Suite 205
Sacramento, CA 95821-5328 - Phone
- (916) 482-3070
- Fax
- (916) 482-3070
- NPI assigned
- Apr 2, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCS 13333 | CA | Primary |
Addresses
Primary practice location
3517 Marconi Ave
Suite 205
Sacramento, CA 95821-5328
Mailing address
3517 Marconi Ave
Suite 205
Sacramento, CA 95821-5328
Phone (916) 482-3070
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 112764 UBS | Other | CA | UNITED BEHAVIORAL HEALTH |
| 7479110 | Other | CA | AETNA BEHAVIORAL HEALTH |
| 049741 | Other | CA | MHN |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120306000108 | CA | Practitioner - Clinical Social Worker | 5395904767 | Practice locations: Sacramento, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
3517 Marconi Ave
Suite 205
Sacramento, CA 95821-5341
Phone (916) 482-3070
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCS 13333 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1063533842",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3517 MARCONI AVE",
"address_2": "SUITE 205",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958215328",
"telephone_number": "916-482-3070",
"fax_number": "916-482-3070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3517 MARCONI AVE",
"address_2": "SUITE 205",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958215328",
"telephone_number": "916-482-3070",
"fax_number": "916-482-3070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEARNE",
"first_name": "GEORGE",
"middle_name": "WALLACE",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS 13333",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED BEHAVIORAL HEALTH",
"identifier": "112764 UBS",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA BEHAVIORAL HEALTH",
"identifier": "7479110",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MHN",
"identifier": "049741",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.