Mary Johnson Neely, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW106852 Issued in CA

Practice address

2001 Santa Monica Blvd Ste 860W
Santa Monica, CA 90404-2189

Phone

(310) 301-7396

Fax

(310) 313-5165

NPI assigned

Feb 23, 2022

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Regents of the University of California Los AngelesGroup PAC ID 4587857727, 84 clinicians

Sud Specialty Group - CaGroup PAC ID 9537534177, 519 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Regents of the University of California Los Angeles

  • Neurology Physician
  • Los Angeles, CA
  • NPI 1609194497
  Medicare reassignment Care Compare group NPD
• Sud Specialty Group - Ca

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Santa Clara, CA
  • NPI 1972138238

  Clinical

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1645574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714521600000",
    "number": "1386390862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 SANTA MONICA BLVD STE 860W",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042189",
            "telephone_number": "310-301-7396",
            "fax_number": "310-313-5165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEELY",
        "first_name": "MARY",
        "middle_name": "JOHNSON",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-23",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW106852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mitch Thomas Neal, DPT
• Ronald Lekeefe Neal II
• Andrea Nee
• Mark Needham, MD
• Stephen Earl Needle, DDS
• Alexandra Marie Neff, AMFT
• Seneca Michelle Negrete, LMFT, APCC
• Victor R Negrete, D.D.S.
• Neil a Martin MD Inc
• Hayley May Neimy, M.S.

• Clinical Social Worker in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2024; 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.

Verify at the official NPI Registry.