Active NPI
Cindy Jean McCarthy, LCSW
- Clinical Social Worker
- Santa Rosa, CA
National Provider Identifier
1366509275
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 12753
- Practice address
- 1030 2ND St
Santa Rosa, CA 95404-6607 - Phone
- (707) 889-1112
- NPI assigned
- Jan 2, 2007
- Last updated
- Sep 24, 2016
- Sex
- Female
- 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 | 12753 | CA | Primary |
Addresses
Primary practice location
1030 2ND St
Santa Rosa, CA 95404-6607
Mailing address
2421 Sunrise PL
Santa Rosa, CA 95409-4034
Phone (707) 889-1112
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160408001955 | CA | Practitioner - Clinical Social Worker | 9931407855 | Practice locations: Santa Rosa, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1983
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
1030 2ND St
Suite 3
Santa Rosa, CA 95404-6607
Phone (707) 889-1112
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12753 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474675200000",
"number": "1366509275",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2421 SUNRISE PL",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954094034",
"telephone_number": "707-889-1112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1030 2ND ST",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954046607",
"telephone_number": "707-889-1112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCARTHY",
"first_name": "CINDY",
"middle_name": "JEAN",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-02",
"last_updated": "2016-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "12753",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Rosa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.