Individual provider Active NPI

Sean McGerald

  • Clinical Social Worker
  • San Diego, CA
National Provider Identifier
1104483866
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ASW126531 Issued in CA
Practice address
3491 Kurtz St Unit 150
San Diego, CA 92110-4430
Phone
(619) 276-1176
NPI assigned
May 28, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Clinical Social Worker 1041C0700X ASW126531 CA Primary

Addresses

Primary practice location

3491 Kurtz St Unit 150
San Diego, CA 92110-4430

Mailing address

3491 Kurtz St Unit 150
San Diego, CA 92110-4430
Phone (619) 276-1176

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
ASW126531CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Telecare Corporation PastSince Dec 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1559001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1104483866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3491 KURTZ ST UNIT 150",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921104430",
            "telephone_number": "619-276-1176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3491 KURTZ ST UNIT 150",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921104430",
            "telephone_number": "619-276-1176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGERALD",
        "first_name": "SEAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-28",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW126531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; 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.