Individual provider Active NPI

Patricia Lee Morin

  • Clinical Social Worker
  • Sausalito, CA
National Provider Identifier
1114439577
Registry record updated Jan 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW87047 Issued in CA
Practice address
347 Eden Roc
Sausalito, CA 94965-1361
Phone
(415) 328-1050
NPI assigned
Oct 25, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X RO33365 NY
Clinical Social Worker 1041C0700X LCSW87047 CA Primary

Addresses

Primary practice location

347 Eden Roc
Sausalito, CA 94965-1361

Mailing address

PO Box 2220
Sausalito, CA 94966-2220
Phone (415) 328-1050

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
LCSW87047CAMDClinical Social Worker
RO33365NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1508889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547683200000",
    "number": "1114439577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2220",
            "city": "SAUSALITO",
            "state": "CA",
            "postal_code": "949662220",
            "telephone_number": "415-328-1050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "347 EDEN ROC",
            "city": "SAUSALITO",
            "state": "CA",
            "postal_code": "949651361",
            "telephone_number": "415-328-1050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORIN",
        "first_name": "PATRICIA",
        "middle_name": "LEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-25",
        "last_updated": "2019-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "RO33365",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW87047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sausalito, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2019; 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.