Individual provider Active NPI

Alexis Flynn

  • Social Worker
  • Long Beach, CA
National Provider Identifier
1255782868
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
LCSW86666 Issued in CA
Practice address
11 Golden SHR Ste 350
Long Beach, CA 90802-4279
Phone
(888) 588-8995
NPI assigned
Jun 24, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X LCSW86666 CA Primary

Addresses

Primary practice location

11 Golden SHR Ste 350
Long Beach, CA 90802-4279

Mailing address

PO Box 981043
Park City, UT 84098-1043

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: No
  • 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
I20240624000931 CA Practitioner - Clinical Social Worker 5092258616 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW86666CAMDSocial Worker
86666CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Foresight Mental Health CurrentSince Jun 4, 2024 Accepting new patients

Locations

235 E Broadway
Ste 314
Long Beach, CA 90802
Phone (530) 240-5855

11 Golden Shore
Ste 350
Long Beach, CA 90802
Phone (562) 253-7688

1000 G St
Ste 125
Sacramento, CA 95814
Phone (510) 345-4379

Interoperability endpoints

  • Direct secure messaging: alexis.flynn.1@25119.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1466726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1255782868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 981043",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840981043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 GOLDEN SHR STE 350",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908024279",
            "telephone_number": "888-588-8995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLYNN",
        "first_name": "ALEXIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-24",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "LCSW86666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.