Individual provider Active NPI

Caroline Cangelosi, LCSW

  • Clinical Social Worker
  • Berkeley, CA
National Provider Identifier
1275659161
Registry record updated Feb 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
26700 Issued in CA
Practice address
837 Addison St
Berkeley, CA 94712
Phone
(510) 981-4100
Fax
(510) 981-4294
NPI assigned
Mar 22, 2007
Last updated
Feb 17, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X ASW 21976 CA
Clinical Social Worker 1041C0700X 26700 CA Primary

Addresses

Primary practice location

837 Addison St
Berkeley, CA 94712

Mailing address

2344 6TH St
Berkeley, CA 94710-2412
Phone (510) 981-4100

Other identifiers 3

IdentifierTypeStateIssuer
11260OtherSFGH INTERNAL USE ONLY
11260OtherCBHS INTERNAL USE ONLY-COMMERCIAL NUMBER
132084OtherCACHN

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
I20210304002508 CA Practitioner - Clinical Social Worker 8123434784 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ASW 21976CAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lifelong Medical Care CurrentSince Feb 16, 2021 Accepting new patients
Lifelong Medical Care CurrentSince Feb 16, 2021 Accepting new patients
Lifelong Medical Care PastSince Jan 10, 2021 Accepting new patients

Locations

2344 6th St
Berkeley, CA 94710
Phone (510) 981-3203

10700 MacArthur Blvd
Ste 14B
Oakland, CA 94605
Phone (510) 563-4300

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613520000000",
    "number": "1275659161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2344 6TH ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947102412",
            "telephone_number": "510-981-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "837 ADDISON ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "94712",
            "telephone_number": "510-981-4100",
            "fax_number": "510-981-4294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANGELOSI",
        "first_name": "CAROLINE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "ASW 21976",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "26700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SFGH INTERNAL USE ONLY",
            "identifier": "11260",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CBHS INTERNAL USE ONLY-COMMERCIAL NUMBER",
            "identifier": "11260",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHN",
            "identifier": "132084",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.