Active NPI
Mikaela Celli
- Clinical Social Worker
- San Carlos, CA
National Provider Identifier
1235508052
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 92894
- Practice address
- 610 Elm St Ste 212
San Carlos, CA 94070-3070 - Phone
- (650) 350-2570
- Fax
- (650) 571-9750
- NPI assigned
- Sep 22, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | ASW67072 | CA | |
| Clinical Social Worker | 1041C0700X | 92894 | CA | Primary |
Addresses
Primary practice location
610 Elm St Ste 212
San Carlos, CA 94070-3070
Mailing address
610 Elm St Ste 212
San Carlos, CA 94070-3070
Phone (650) 350-2570
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 92894 | Other | CA | BOARD OF BEHAVIORAL SCIENCES |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ASW67072 | CA | MD | Mental Health Counselor |
| 92894 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643241600000",
"number": "1235508052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "610 ELM ST STE 212",
"city": "SAN CARLOS",
"state": "CA",
"postal_code": "940703070",
"telephone_number": "650-350-2570",
"fax_number": "408-259-2273"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "610 ELM ST STE 212",
"city": "SAN CARLOS",
"state": "CA",
"postal_code": "940703070",
"telephone_number": "650-350-2570",
"fax_number": "650-571-9750"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CELLI",
"first_name": "MIKAELA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-09-22",
"last_updated": "2022-01-27",
"certification_date": "2022-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "ASW67072",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "92894",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF BEHAVIORAL SCIENCES",
"identifier": "92894",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Carlos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.