Individual provider Active NPI

Dennis Richard Wellwood, LCSW

  • Clinical Social Worker
  • Camarillo, CA
National Provider Identifier
1073638672
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS12539 Issued in CA
Practice address
500 Airport Way
Camarillo, CA 93010-8500
Phone
(805) 388-4230
NPI assigned
Mar 20, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 LCS12539 CA Primary

Addresses

Primary practice location

500 Airport Way
Camarillo, CA 93010-8500

Mailing address

756 Mission Dr
Camarillo, CA 93010-1151
Phone (805) 482-8372

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

LicenseStateTypeSpecialty
LCS12539CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
County of Ventura PastSince Jun 1, 2023 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": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073638672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "756 MISSION DR",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930101151",
            "telephone_number": "805-482-8372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 AIRPORT WAY",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930108500",
            "telephone_number": "805-388-4230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLWOOD",
        "first_name": "DENNIS",
        "middle_name": "RICHARD",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS12539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camarillo, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.