Active NPI
Jeffrey S Bormaster, LCSW
- Clinical Social Worker
- Palm Springs, CA
National Provider Identifier
1295932804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS15130
- Practice address
- 2193 S Calle Palo Fierro
Palm Springs, CA 92264-9079 - Phone
- (760) 333-9056
- NPI assigned
- Jun 27, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCS15130 | CA | Primary |
Addresses
Primary practice location
2193 S Calle Palo Fierro
Palm Springs, CA 92264-9079
Mailing address
2193 S Calle Palo Fierro
Palm Springs, CA 92264-9079
Phone (760) 333-9056
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LCS15130 | Other | CA | LCSW LICENSE NO |
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
| License | State | Type | Specialty |
|---|---|---|---|
| LCS15130 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1295932804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2193 S CALLE PALO FIERRO",
"city": "PALM SPRINGS",
"state": "CA",
"postal_code": "922649079",
"telephone_number": "760-333-9056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2193 S CALLE PALO FIERRO",
"city": "PALM SPRINGS",
"state": "CA",
"postal_code": "922649079",
"telephone_number": "760-333-9056"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BORMASTER",
"first_name": "JEFFREY",
"middle_name": "S",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS15130",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LCSW LICENSE NO",
"identifier": "LCS15130",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Palm Springs, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.