Individual provider Active NPI

Brenda Lyn Coon, LCSW

  • Clinical Social Worker
  • Palmdale, CA
National Provider Identifier
1376681874
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS 27442 Issued in CA
Practice address
2323A E. Palmdale Boulevard
Palmdale, CA 93550
Phone
(661) 223-3800
Fax
(661) 537-2937
NPI assigned
Feb 5, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

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 LCS 27442 CA Primary

Addresses

Primary practice location

2323A E. Palmdale Boulevard
Palmdale, CA 93550

Mailing address

PO Box 149
Lancaster, CA 93584-0149
Phone (213) 605-3820

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS 27442CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1376681874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 149",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935840149",
            "telephone_number": "213-605-3820",
            "fax_number": "661-449-3772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2323A E. PALMDALE BOULEVARD",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "93550",
            "telephone_number": "661-223-3800",
            "fax_number": "661-537-2937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COON",
        "first_name": "BRENDA",
        "middle_name": "LYN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 27442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmdale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; 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.