Individual provider Active NPI

Melanie Ann Ulvila, LCSW

  • Clinical Social Worker
  • Ukiah, CA
National Provider Identifier
1184779696
Registry record updated Apr 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
25000 Issued in CA
Practice address
776 S State St Ste 107
Ukiah, CA 95482-5858
Phone
(707) 463-4915
Fax
(707) 463-4917
NPI assigned
Jan 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2021

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 25000 CA Primary

Addresses

Primary practice location

776 S State St Ste 107
Ukiah, CA 95482-5858

Mailing address

776 S State St Ste 107
Ukiah, CA 95482-5858
Phone (707) 463-4915

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
I20110209000911 CA Practitioner - Clinical Social Worker 5193905073 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Madrone St
Willits, CA 95490-4225
Phone (707) 459-6801

333 Laws Ave
Ukiah, CA 95482-6540
Phone (458) 292-2167

45 Hazel St
Willits, CA 95490-4222
Phone (707) 456-9600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25000CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Consolidated Tribal Health Project, Inc. CurrentSince Oct 21, 2010 Accepting new patients
Mendocino Community Health Clinic, Inc. Current Accepting new patients
Mendocino Community Health Clinic, Inc. CurrentSince May 10, 2022 Accepting new patients

Locations

6991 N State St
Redwood Vly, CA 95470
Phone (707) 467-5620

333 Laws Ave
Ukiah, CA 95482
Phone (707) 463-1113

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15156/brand/1/csg/1/fhir/r4

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618790400000",
    "number": "1184779696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "776 S STATE ST STE 107",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954825858",
            "telephone_number": "707-463-4915",
            "fax_number": "707-463-4917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "776 S STATE ST STE 107",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954825858",
            "telephone_number": "707-463-4915",
            "fax_number": "707-463-4917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULVILA",
        "first_name": "MELANIE",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2021-04-19",
        "certification_date": "2020-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "25000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ukiah, CA

Sources for this page

Verify at the official NPI Registry.