Individual provider Active NPI

Marci Lee Kyle, LCSW

  • Clinical Social Worker
  • San Diego, CA
National Provider Identifier
1174981500
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
78555 Issued in CA
Practice address
5677 Division St
San Diego, CA 92114-6409
Phone
(619) 508-5525
NPI assigned
Jan 30, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

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 78555 CA Primary

Addresses

Primary practice location

5677 Division St
San Diego, CA 92114-6409

Mailing address

5677 Division St
San Diego, CA 92114-6409
Phone (619) 508-5525

Other practice location 1

4094 4th Ave
San Diego, CA 92103-2143
Phone (619) 515-2545

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.thelotuscounselingcenter.com Direct

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
I20171006001813 CA Practitioner - Clinical Social Worker 4183908825 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4065 3Rd Ave
San Diego, CA 92103-2184
Phone (619) 515-2545

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
78555CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers of San Diego, Inc. CurrentSince Sep 27, 2017 Accepting new patients
Family Health Centers of San Diego, Inc Current Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Sep 27, 2017 Accepting new patients

Locations

4094 4th Ave
San Diego, CA 92103
Phone (619) 515-2545

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

Organizations & group practices 3

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": "1454112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1174981500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5677 DIVISION ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921146409",
            "telephone_number": "619-508-5525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5677 DIVISION ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921146409",
            "telephone_number": "619-508-5525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4094 4th Ave",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921032143",
            "country_code": "US",
            "telephone_number": "619-515-2545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KYLE",
        "first_name": "MARCI",
        "middle_name": "LEE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-30",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "78555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.thelotuscounselingcenter.com",
            "affiliation": "N",
            "endpointDescription": "URL",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5677 Division St",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921146409",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.