Active NPI
Laura Monica Mares, LCSW
- Clinical Social Worker
- Ukiah, CA
National Provider Identifier
1063538155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS12742
- Practice address
- 260 Hospital Dr.
Suite #101
Ukiah, CA 95482 - Phone
- (707) 463-8000
- Fax
- (707) 462-1111
- NPI assigned
- Mar 21, 2007
- Last updated
- Apr 1, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | LCS12742 | CA | |
| Clinical Social Worker | 1041C0700X | LCS12742 | CA | Primary |
Addresses
Primary practice location
260 Hospital Dr.
Suite #101
Ukiah, CA 95482
Mailing address
P.O. Box 2739
Ukiah, CA 95482
Phone (707) 463-8000
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 |
|---|---|---|---|---|
| I20160804000576 | CA | Practitioner - Clinical Social Worker | 7810281409 | Practice locations: Ukiah, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1982
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
359 N Oak St
Ukiah, CA 95482-4302
Phone (707) 391-4043
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCS12742 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1238544000000",
"number": "1063538155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 2739",
"city": "UKIAH",
"state": "CA",
"postal_code": "95482",
"telephone_number": "707-463-8000",
"fax_number": "707-462-1111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "260 HOSPITAL DR.",
"address_2": "SUITE #101",
"city": "UKIAH",
"state": "CA",
"postal_code": "95482",
"telephone_number": "707-463-8000",
"fax_number": "707-462-1111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARES",
"first_name": "LAURA",
"middle_name": "MONICA",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-21",
"last_updated": "2009-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "LCS12742",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS12742",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ukiah, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2009; 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.