Active NPI
Michelle Lin Pow-Anpongkul, LCSW
- Clinical Social Worker
- Culver City, CA
National Provider Identifier
1073030896
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 99111
- Practice address
- 4760 Sepulveda Blvd.
Culver City, CA 90230 - Phone
- (310) 390-6612
- Fax
- (310) 398-5690
- NPI assigned
- Aug 23, 2017
- Last updated
- Dec 17, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 84555 | CA | |
| Case Manager/Care Coordinator | 171M00000X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Clinical Social Worker | 1041C0700X | 99111 | CA | Primary |
Addresses
Primary practice location
4760 Sepulveda Blvd.
Culver City, CA 90230
Mailing address
4858 W Pico Blvd Ste 325
Los Angeles, CA 90019-4225
Phone (310) 751-0552
Other practice location 1
520 S Lafayette Park Place 3rd Floor
La, CA 90057
Phone (213) 252-2100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 99111 | CA | MD | Clinical Social Worker |
| 84555 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639699200000",
"number": "1073030896",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4858 W PICO BLVD STE 325",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900194225",
"telephone_number": "310-751-0552"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4760 SEPULVEDA BLVD.",
"city": "CULVER CITY",
"state": "CA",
"postal_code": "90230",
"telephone_number": "310-390-6612",
"fax_number": "310-398-5690"
}
],
"practiceLocations": [
{
"address_1": "520 S Lafayette Park Place 3rd Floor",
"address_purpose": "LOCATION",
"city": "LA",
"state": "CA",
"postal_code": "90057",
"country_code": "US",
"telephone_number": "213-252-2100",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "POW-ANPONGKUL",
"first_name": "MICHELLE",
"middle_name": "LIN",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-23",
"last_updated": "2021-12-17",
"certification_date": "2021-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "84555",
"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": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "99111",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Culver City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.