Cheyenne E Monroe-Backus, LCSW
Individual provider Active NPI Clinical Social Worker · Edwards, CA
NPI 1194209296 · NPPES record last updated Sep 22, 2023
Key facts
- NPI
- 1194209296
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 4826 (HI)
- Practice address
- 30 Nightingale Rd BLDG 5513
Edwards, CA 93524-1022 - Phone
- (661) 277-5291
- Fax
- (661) 277-6327
- NPI assigned
- Sep 24, 2018
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 104564 | NY | MD | Counselor |
| 35052 | NY | MD | Addiction (Substance Use Disorder) Counselor |
| 4826 | HI | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 104564 | NY | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 35052 | NY | |
| Social Worker | 104100000X | 104564 | NY | |
| Clinical Social Worker | 1041C0700X | 4826 | HI | Yes |
Addresses
Primary practice location
30 Nightingale Rd BLDG 5513
Edwards, CA 93524-1022
Mailing address
2801 Schley Ave Apt 6C
Bronx, NY 10465-2713
Phone (347) 818-0851
Other providers in Edwards, CA
- Dyann Hanes
- Shelina Hardwick-Moses
- Pang Ko
- Phillip Lopiccolo
- Franklin Miranda
- David George Morrison Jr.
- Tracy Adell Neal-Walden
- Rebecca Michelle Orr
- Austin Puente
- Carolina Ramirez
All providers in Edwards, CA · Clinical Social Worker in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 22, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.