Individual provider Active NPI

Karen Depriest, LCSW, ACSW

  • Clinical Social Worker
  • Mission Viejo, CA
National Provider Identifier
1306957501
Registry record updated Jul 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS21183 Issued in CA
Practice address
26391 Crown Valley Pkwy
Suite 110
Mission Viejo, CA 92691-7309
Phone
(909) 225-6634
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2008

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 LCS21183 CA Primary

Addresses

Primary practice location

26391 Crown Valley Pkwy
Suite 110
Mission Viejo, CA 92691-7309

Mailing address

PO Box 2606
Mission Viejo, CA 92690-0606
Phone (909) 225-6634

Other identifiers 1

IdentifierTypeStateIssuer
LCS21183OtherCAMEDICARE

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
I20050222000983 CA Practitioner - Clinical Social Worker 4183677800 Practice locations: Mission Viejo, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

26431 Crown Valley Pkwy
Suite 160
Mission Viejo, CA 92691-7201
Phone (909) 225-6634

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS21183CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216252800000",
    "number": "1306957501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2606",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926900606",
            "telephone_number": "909-225-6634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26391 CROWN VALLEY PKWY",
            "address_2": "SUITE 110",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926917309",
            "telephone_number": "909-225-6634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPRIEST",
        "first_name": "KAREN",
        "credential": "LCSW, ACSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2008-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS21183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "LCS21183",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

Verify at the official NPI Registry.