Active NPI
Tasha Eddy
- Mental Health Counselor
- Long Beach, CA
National Provider Identifier
1366814048
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- ASW67992
- Practice address
- 3530 Atlantic Ave
Suite 210
Long Beach, CA 90807-4569 - Phone
- (562) 424-1886
- Fax
- (562) 424-2296
- NPI assigned
- Oct 21, 2015
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | ASW67992 | CA | Primary |
Addresses
Primary practice location
3530 Atlantic Ave
Suite 210
Long Beach, CA 90807-4569
Mailing address
3530 Atlantic Ave
Suite 210
Long Beach, CA 90807-4569
Phone (562) 424-1886
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 |
|---|---|---|---|---|
| I20250128003710 | CA | Practitioner - Clinical Social Worker | 9335678879 | Practice locations: Los Angeles, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
3685 Motor Ave
Suite 220
Los Angeles, CA 90034-5746
Phone (818) 359-1575
4004 Van Buren PL
Culver City, CA 90232-2828
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ASW67992 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1445385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1477008000000",
"number": "1366814048",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3530 ATLANTIC AVE",
"address_2": "SUITE 210",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908074569",
"telephone_number": "562-424-1886",
"fax_number": "562-424-2296"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3530 ATLANTIC AVE",
"address_2": "SUITE 210",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908074569",
"telephone_number": "562-424-1886",
"fax_number": "562-424-2296"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDDY",
"first_name": "TASHA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-10-21",
"last_updated": "2016-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "ASW67992",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.