Individual provider Active NPI

Julie Ann Kirkes, LCSW

  • Clinical Social Worker
  • Travis Afb, CA
National Provider Identifier
1285940320
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW86960 Issued in CA
Practice address
103 Bodin Circle, BLD 778
VA-Mental Health
Travis Afb, CA 94535
Phone
(707) 437-1853
Fax
(916) 561-7471
NPI assigned
Aug 26, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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 LCSW86960 CA Primary

Addresses

Primary practice location

103 Bodin Circle, BLD 778
VA-Mental Health
Travis Afb, CA 94535

Mailing address

103 Bodin Circle, BLD 778
VA-Mental Health
Travis Afb, CA 94535
Phone (707) 437-1853

Other practice location 1

750 S Solano Dr
Las Cruces, NM 88001
Phone (575) 642-0984

Other identifiers 1

IdentifierTypeStateIssuer
83225102MedicaidNM

Other names 1

  • Julie Ann Markham/Grenko/Tracy Former name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LCSW86960CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Julie Kirkes 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.

NPI Registry JSON

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

{
    "created_epoch": "1282780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1285940320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 BODIN CIRCLE, BLD 778",
            "address_2": "VA-MENTAL HEALTH",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "94535",
            "telephone_number": "707-437-1853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 BODIN CIRCLE, BLD 778",
            "address_2": "VA-MENTAL HEALTH",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "94535",
            "telephone_number": "707-437-1853",
            "fax_number": "916-561-7471"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "750 S Solano Dr",
            "address_purpose": "LOCATION",
            "city": "Las Cruces",
            "state": "NM",
            "postal_code": "88001",
            "country_code": "US",
            "telephone_number": "575-642-0984",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIRKES",
        "first_name": "JULIE",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-26",
        "last_updated": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW86960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "83225102",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIE",
            "last_name": "MARKHAM/GRENKO/TRACY",
            "middle_name": "ANN",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Travis Afb, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.