Individual provider Active NPI

Catherine Brooks, LCSW

  • Clinical Social Worker
  • Encinitas, CA
National Provider Identifier
1114270725
Registry record updated Jun 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS 27017 Issued in CA
Practice address
285 N El Camino Real
Suite 218
Encinitas, CA 92024-5383
Phone
(760) 525-9565
NPI assigned
Oct 19, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2014

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 LCS 27017 CA Primary

Addresses

Primary practice location

285 N El Camino Real
Suite 218
Encinitas, CA 92024-5383

Mailing address

730 Pacifica Way
Encinitas, CA 92024-1341
Phone (760) 525-9656

Other identifiers 1

IdentifierTypeStateIssuer
GZ017AOtherCAMEDICARE PTAN

Other names 1

  • Ms. Catherine Vernon Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 1, 2024 through Apr 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS 27017CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Good Therapy San Diego Clinical PastSince Oct 30, 2012 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": "1350604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402444800000",
    "number": "1114270725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 PACIFICA WAY",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920241341",
            "telephone_number": "760-525-9656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 N EL CAMINO REAL",
            "address_2": "SUITE 218",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920245383",
            "telephone_number": "760-525-9565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "CATHERINE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-19",
        "last_updated": "2014-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 27017",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "GZ017A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CATHERINE",
            "last_name": "VERNON",
            "prefix": "MS.",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Encinitas, CA

Sources for this page

Verify at the official NPI Registry.