Individual provider Active NPI

Lin K McNulty, JD, LCSW

  • Mental Health Counselor
  • Grass Valley, CA
National Provider Identifier
1184747099
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
19591 Issued in CA
Practice address
655 S Auburn St
Grass Valley, CA 95945-7535
Phone
(530) 274-7560
NPI assigned
Apr 6, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 19591 CA Primary

Addresses

Primary practice location

655 S Auburn St
Grass Valley, CA 95945-7535

Mailing address

P.O. Box 2149
Nevada City, CA 95959
Phone (530) 274-7560

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
I20150601001713 CA Practitioner - Clinical Social Worker 2163686973 Practice locations: Grass Valley, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Southern California Keck School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

655 S Auburn St
Grass Valley, CA 95945-7535
Phone (530) 274-7560

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Juris Doctor

State licenses

LicenseStateTypeSpecialty
19591CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184747099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 2149",
            "city": "NEVADA CITY",
            "state": "CA",
            "postal_code": "95959",
            "telephone_number": "530-274-7560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 S AUBURN ST",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959457535",
            "telephone_number": "530-274-7560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNULTY",
        "first_name": "LIN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "JD, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "19591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grass Valley, CA

Sources for this page

Verify at the official NPI Registry.