Individual provider Active NPI

Mary I Akstin, LCSW

  • Clinical Social Worker
  • Rancho Cucamonga, CA
National Provider Identifier
1396462693
Registry record updated Oct 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW17978 Issued in CA
Practice address
7365 Carnelian St Ste 202
Rancho Cucamonga, CA 91730-1157
Phone
(909) 281-1557
NPI assigned
Oct 26, 2022
Last updated
Oct 26, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2022

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 LCSW17978 CA Primary

Addresses

Primary practice location

7365 Carnelian St Ste 202
Rancho Cucamonga, CA 91730-1157

Mailing address

630 W Bonita Ave Apt 12a
Claremont, CA 91711-4585
Phone (909) 802-9548

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
I20251208000875 CA Practitioner - Clinical Social Worker 2860985801 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Merrell Family Counseling IncGroup PAC ID 7810413739, 4 clinicians

Practice addresses (Care Compare)

7365 Carnelian St
Suite 202
Rancho Cucamonga, CA 91730-1157
Phone (909) 281-1557

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW17978CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Merrell Family Counseling, Inc. CurrentSince Oct 20, 2025 Accepting new patients

Locations

7365 Carnelian St
Ste 202
Rancho Cucamonga, CA 91730
Phone (909) 281-1557

7365 Carnelian St
Ste 240
Rancho Cucamonga, CA 91730
Phone (909) 256-3245

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": "1666742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666742400000",
    "number": "1396462693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 W BONITA AVE APT 12A",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917114585",
            "telephone_number": "909-802-9548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7365 CARNELIAN ST STE 202",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917301157",
            "telephone_number": "909-281-1557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AKSTIN",
        "first_name": "MARY",
        "middle_name": "I",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-26",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW17978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

Verify at the official NPI Registry.