Active NPI
Wendy Burns, LCSW
- Clinical Social Worker
- Arcata, CA
National Provider Identifier
1144579582
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 74439
- Practice address
- 665 F St Ste D
Arcata, CA 95521-6364 - Phone
- (707) 825-1252
- NPI assigned
- Aug 30, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 36372 | CA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Clinical Social Worker | 1041C0700X | 74439 | CA | Primary |
Addresses
Primary practice location
665 F St Ste D
Arcata, CA 95521-6364
Mailing address
665 F St Ste D
Arcata, CA 95521-6364
Phone (707) 825-1252
Other practice location 1
1802 California St
Eureka, CA 95501-2808
Phone (707) 443-7358 ext. 324
Other practice location 2
1100 California St
Eureka, CA 95501-1621
Phone (707) 269-2001
Other practice location 3
537 9th St
Eureka, CA 95501-1861
Phone (707) 269-2001
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
| License | State | Type | Specialty |
|---|---|---|---|
| 74439 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Redwood Community Action Agency | Past | 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.
-
dba Youth Services Bureau
- Case Manager/Care Coordinator
- Eureka, CA
- NPI 1578699260
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583280000000",
"number": "1144579582",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "665 F ST STE D",
"city": "ARCATA",
"state": "CA",
"postal_code": "955216364",
"telephone_number": "707-825-1252"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "665 F ST STE D",
"city": "ARCATA",
"state": "CA",
"postal_code": "955216364",
"telephone_number": "707-825-1252"
}
],
"practiceLocations": [
{
"address_1": "1802 California St",
"address_purpose": "LOCATION",
"city": "Eureka",
"state": "CA",
"postal_code": "955012808",
"country_code": "US",
"telephone_number": "707-443-7358 x324",
"fax_number": "707-443-1092",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1100 California St",
"address_purpose": "LOCATION",
"city": "Eureka",
"state": "CA",
"postal_code": "955011621",
"country_code": "US",
"telephone_number": "707-269-2001",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "537 9th St",
"address_purpose": "LOCATION",
"city": "Eureka",
"state": "CA",
"postal_code": "955011861",
"country_code": "US",
"telephone_number": "707-269-2001",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BURNS",
"first_name": "WENDY",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-30",
"last_updated": "2020-03-04",
"certification_date": "2020-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "CA",
"license": "36372",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "74439",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Arcata, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.