Active NPI
Mary L Kirby, L.C.S.W.
- Clinical Social Worker
- Palo Cedro, CA
National Provider Identifier
1245429547
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS20049
- Practice address
- 8808 Maynard Rd
Palo Cedro, CA 96073-9693 - Phone
- (530) 515-6884
- NPI assigned
- Oct 23, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCS20049 | CA | Primary |
Addresses
Primary practice location
8808 Maynard Rd
Palo Cedro, CA 96073-9693
Mailing address
8808 Maynard Rd
Palo Cedro, CA 96073-9693
Phone (530) 515-6884
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCS20049 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| His Ideas, Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Foster Care Agency
- Redding, CA
- NPI 1386416774
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193097600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1448928000000",
"number": "1245429547",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8808 MAYNARD RD",
"city": "PALO CEDRO",
"state": "CA",
"postal_code": "960739693",
"telephone_number": "530-515-6884"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8808 MAYNARD RD",
"city": "PALO CEDRO",
"state": "CA",
"postal_code": "960739693",
"telephone_number": "530-515-6884"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIRBY",
"first_name": "MARY",
"middle_name": "L",
"name_prefix": "Ms.",
"credential": "L.C.S.W.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-10-23",
"last_updated": "2015-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS20049",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palo Cedro, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.