Individual provider Active NPI

Monica Marie Mejia-Hannaman

  • Clinical Social Worker
  • Elizabeth City, NC
National Provider Identifier
1205274172
Registry record updated Aug 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
101825 Issued in TX
Practice address
206 Orchard Dr
Elizabeth City, NC 27909-9325
Phone
(562) 743-0806
NPI assigned
Jun 12, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2024

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 101825 TX Primary

Addresses

Primary practice location

206 Orchard Dr
Elizabeth City, NC 27909-9325

Mailing address

206 Orchard Dr
Elizabeth City, NC 27909-9325
Phone (562) 743-0806

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
I20241003001197 CA Practitioner - Clinical Social Worker 4385175124 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Blue Moon Senior Counseling of California LLCGroup PAC ID 9335360981, 79 clinicians

Practice addresses (Care Compare)

Palm Springs, CA 92264
Phone (855) 241-7160

39905 Via Scena
Unit 218
Palm Desert, CA 92260-1827
Phone (855) 241-7160

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
101825TXMDClinical Social Worker
91861CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
K&M Neuropsychology, a Psychology Corporation CurrentSince Jul 1, 2025 Accepting new patients
Blue Moon Senior Counseling of California LLC Clinical CurrentSince Aug 15, 2024 Accepting new patients

Locations

100 Shoreline Hwy
Ste B100
Mill Valley, CA 94941
Phone (415) 877-4408

10204 Bode St
Ste B
Plainfield, IL 60585
Phone (630) 229-6462

Organizations & group practices 2

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": "1370995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723334400000",
    "number": "1205274172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 ORCHARD DR",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279099325",
            "telephone_number": "562-743-0806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 ORCHARD DR",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279099325",
            "telephone_number": "562-743-0806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEJIA-HANNAMAN",
        "first_name": "MONICA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-12",
        "last_updated": "2024-08-11",
        "certification_date": "2024-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "101825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth City, NC

Sources for this page

Verify at the official NPI Registry.