Individual provider Active NPI

Maureen Doris Aquilina, LCSW

  • Clinical Social Worker
  • Las Vegas, NV
National Provider Identifier
1174899694
Registry record updated Mar 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6135-C Issued in NV
Practice address
7860 West Sahara Avenue
Ste 170
Las Vegas, NV 89117
Phone
(702) 538-9476
NPI assigned
Mar 29, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2012

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 6135-C NV Primary

Addresses

Primary practice location

7860 West Sahara Avenue
Ste 170
Las Vegas, NV 89117

Mailing address

PO Box 401298
Las Vegas, NV 89140-1298
Phone (702) 285-3342

Other identifiers 1

IdentifierTypeStateIssuer
1041C0700XOtherNVTAXONOMY CODE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201130002025 CA Practitioner - Clinical Social Worker 3476964255 Practice locations: Dana Point, CA; San Clemente, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

Dana Point, CA 92629
Phone (949) 339-9850

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6135-CNVMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1332979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332979200000",
    "number": "1174899694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 401298",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891401298",
            "telephone_number": "702-285-3342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7860 WEST SAHARA AVENUE",
            "address_2": "STE 170",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89117",
            "telephone_number": "702-538-9476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AQUILINA",
        "first_name": "MAUREEN",
        "middle_name": "DORIS",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-29",
        "last_updated": "2012-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "6135-C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMY CODE",
            "identifier": "1041C0700X",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.