Individual provider Active NPI

Lily E. Mogartoff, LCSW

  • Clinical Social Worker
  • Costa Mesa, CA
National Provider Identifier
1396076097
Registry record updated Feb 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
20852 Issued in CA
Practice address
151 Kalmus Dr
Suite K-1
Costa Mesa, CA 92626-5988
Phone
(800) 577-4701
Fax
(714) 242-9268
NPI assigned
Jan 19, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2011

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 20852 CA Primary

Addresses

Primary practice location

151 Kalmus Dr
Suite K-1
Costa Mesa, CA 92626-5988

Mailing address

151 Kalmus Dr
Suite K-1
Costa Mesa, CA 92626-5988
Phone (800) 577-4701

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
20852CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1263859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297814400000",
    "number": "1396076097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 KALMUS DR",
            "address_2": "SUITE K-1",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926265988",
            "telephone_number": "800-577-4701",
            "fax_number": "714-242-9268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 KALMUS DR",
            "address_2": "SUITE K-1",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926265988",
            "telephone_number": "800-577-4701",
            "fax_number": "714-242-9268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOGARTOFF",
        "first_name": "LILY",
        "middle_name": "E.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-19",
        "last_updated": "2011-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "20852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2011; 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.