Individual provider Active NPI

Sally Patricia Morris, LCSW

  • Clinical Social Worker
  • Costa Mesa, CA
National Provider Identifier
1073047296
Registry record updated Apr 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS21382 Issued in CA
Practice address
252 Hill PL
Costa Mesa, CA 92627-1313
Phone
(949) 646-3671
NPI assigned
Apr 13, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCS21382 CA Primary

Addresses

Primary practice location

252 Hill PL
Costa Mesa, CA 92627-1313

Mailing address

252 Hill PL
Costa Mesa, CA 92627-1313
Phone (949) 646-3671

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050126000659 CA Practitioner - Clinical Social Worker 4082664156 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
K Allen Family Therapist IncGroup PAC ID 1951529775, 9 clinicians

Practice addresses (Care Compare)

4 Collingwood
Aliso Viejo, CA 92656-1939
Phone (949) 630-0584

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS21382CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
K Allen Family Therapist Inc CurrentSince Apr 13, 2017 Accepting new patients

Organizations & group practices 1

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": "1492041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492041600000",
    "number": "1073047296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "252 HILL PL",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926271313",
            "telephone_number": "949-646-3671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "252 HILL PL",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926271313",
            "telephone_number": "949-646-3671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRIS",
        "first_name": "SALLY",
        "middle_name": "PATRICIA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-13",
        "last_updated": "2017-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS21382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

Verify at the official NPI Registry.