Individual provider Active NPI

Marylou McLeod

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1386060762
Registry record updated Jan 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
107666 Issued in CA
Practice address
100 W 1St St FL 6
Los Angeles, CA 90012-4112
Phone
(213) 972-7000
NPI assigned
Mar 10, 2014
Last updated
Jan 19, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2026

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 107666 CA Primary

Addresses

Primary practice location

100 W 1St St FL 6
Los Angeles, CA 90012-4112

Mailing address

100 W 1St St FL 6
Los Angeles, CA 90012-4112

Other practice location 1

510 S Vermont Ave
Los Angeles, CA 90020-1912
Phone (213) 972-7000

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
I20220801001693 CA Practitioner - Clinical Social Worker 0648652180

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
107666CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness & Equity Foundation Inc. CurrentSince Jul 17, 2025 Accepting new patients

Locations

969 E 12th St
Ste D
Los Angeles, CA 90021
Phone (408) 341-9606

160 N Luring Dr
Ste D
Palm Springs, CA 92262
Phone (408) 341-9606

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1394409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768780800000",
    "number": "1386060762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 W 1ST ST FL 6",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900124112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W 1ST ST FL 6",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900124112",
            "telephone_number": "213-972-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "510 S Vermont Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900201912",
            "country_code": "US",
            "telephone_number": "213-972-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCLEOD",
        "first_name": "MARYLOU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-10",
        "last_updated": "2026-01-19",
        "certification_date": "2026-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "107666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.