Individual provider Active NPI

Mitchell Marc Cuomo, LCSW

  • Clinical Social Worker
  • San Diego, CA
National Provider Identifier
1275915654
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW94880 Issued in CA
Practice address
3340 Kemper St
San Diego, CA 92110-4906
Phone
(760) 227-1418
NPI assigned
Jun 23, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

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 LCSW94880 CA Primary

Addresses

Primary practice location

3340 Kemper St
San Diego, CA 92110-4906

Mailing address

3340 Kemper St
San Diego, CA 92110-4906
Phone (760) 227-1418

Other practice location 1

213 Center St
Hanford, CA 93230-4408
Phone (559) 415-6737

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
I20200728000260 CA Practitioner - Clinical Social Worker 1355766734 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW94880CAMDClinical Social Worker
94880CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Systems, Inc. CurrentSince Jul 17, 2020 Accepting new patients
Mental Health Systems, Inc. CurrentSince Jul 17, 2020 Accepting new patients
Mental Health Systems, Inc. Current Accepting new patients

Locations

9465 Farnham St
San Diego, CA 92123
Phone (858) 576-4311

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1435017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761004800000",
    "number": "1275915654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 KEMPER ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921104906",
            "telephone_number": "760-227-1418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3340 KEMPER ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921104906",
            "telephone_number": "760-227-1418"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "213 Center St",
            "address_purpose": "LOCATION",
            "city": "Hanford",
            "state": "CA",
            "postal_code": "932304408",
            "country_code": "US",
            "telephone_number": "559-415-6737",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUOMO",
        "first_name": "MITCHELL",
        "middle_name": "MARC",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-23",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW94880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.