Individual provider Active NPI

Karen Johnsen Gilmore, L.C.S,W

  • Clinical Social Worker
  • Palmdale, CA
National Provider Identifier
1275724775
Registry record updated May 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS17718 Issued in CA
Practice address
1529 E Palmdale Blvd Ste 210
Palmdale, CA 93550-2029
Phone
(661) 902-1962
NPI assigned
Aug 8, 2007
Last updated
May 26, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCS17718 CA Primary

Addresses

Primary practice location

1529 E Palmdale Blvd Ste 210
Palmdale, CA 93550-2029

Mailing address

190 Sierra CT
Ste.C-4
Palmdale, CA 93550-7607
Phone (661) 902-1962

Other practice location 1

190 Sierra Ct
ste.C-4
Palmdale, CA 93550-7607
Phone (661) 902-1962

Other identifiers 1

IdentifierTypeStateIssuer
00007301MedicaidCA

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
I20110912000222 CA Practitioner - Clinical Social Worker 5597729673 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS17718CAMDClinical Social Worker
254COMDInternal Medicine Physician
17718CAMDSNF/Subacute Care Certified Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
JWCH Institute Inc CurrentSince Nov 18, 2019 Accepting new patients
Karen J Gilmore Licensed Clinical Social Worker Inc Clinical Current Accepting new patients
JWCH Institute Inc CurrentSince Nov 18, 2019 Accepting new patients

Locations

5650 Jillson St
Commerce, CA 90040
Phone (213) 484-1186

45104 10th St W
Lancaster, CA 93534
Phone (661) 941-9543

954 N Vermont Ave
Los Angeles, CA 90029
Phone (323) 454-4850

12360 Firestone Blvd
Norwalk, CA 90650
Phone (562) 281-0305

190 Sierra Ct
Ste C4
Palmdale, CA 93550
Phone (661) 463-0496

2151 E Palmdale Blvd
Palmdale, CA 93550
Phone (661) 273-3222

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": "1186531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653523200000",
    "number": "1275724775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 SIERRA CT",
            "address_2": "STE.C-4",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935507607",
            "telephone_number": "661-902-1962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1529 E PALMDALE BLVD STE 210",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935502029",
            "telephone_number": "661-902-1962"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "190 Sierra Ct",
            "address_2": "ste.C-4",
            "address_purpose": "LOCATION",
            "city": "Palmdale",
            "state": "CA",
            "postal_code": "935507607",
            "country_code": "US",
            "telephone_number": "661-902-1962",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILMORE",
        "first_name": "KAREN",
        "middle_name": "JOHNSEN",
        "name_prefix": "Mrs.",
        "credential": "L.C.S,W",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-08",
        "last_updated": "2022-05-26",
        "certification_date": "2022-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS17718",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00007301",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmdale, CA

Sources for this page

Verify at the official NPI Registry.