Phyllis C. Heenan, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW9057 Issued in CA

Practice address

47 Knollwood Dr
Aptos, CA 95003-3401

Phone

(831) 428-3771

Fax

(831) 661-5197

NPI assigned

Mar 5, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

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

Specialty

Clinical Social Worker

Education

Other, 1975

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1225167398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 KNOLLWOOD DR",
            "city": "APTOS",
            "state": "CA",
            "postal_code": "950033401",
            "telephone_number": "831-428-3771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 KNOLLWOOD DR",
            "city": "APTOS",
            "state": "CA",
            "postal_code": "950033401",
            "telephone_number": "831-428-3771",
            "fax_number": "831-661-5197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEENAN",
        "first_name": "PHYLLIS",
        "middle_name": "C.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-05",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW9057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "phylheenan@comcast.net",
            "affiliation": "N",
            "endpointDescription": "phylheenan@comcast.net",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "47 Knollwood Dr",
            "city": "Aptos",
            "state": "CA",
            "country_code": "US",
            "postal_code": "950033401",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "phylheenan@comcast.net",
            "affiliation": "N",
            "endpointDescription": "phylheenan@comcast.net",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "phylheen@comcast.net",
            "address_1": "47 Knollwood Dr",
            "city": "Aptos",
            "state": "CA",
            "country_code": "US",
            "postal_code": "950033401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Clinical Social Worker in Aptos, CA
• Providers in Aptos, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.