NPIMap

Organization Active NPI

Primavera Counseling Licensed Clinical Social Worker Corporation

  • Clinical Social Worker
  • Los Alamitos, CA
National Provider Identifier
1407424609
Registry record updated Jun 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
PRIMAVERA COUNSELING LICENSED CLINICAL SOCIAL WORKER CORPORATION
Practice address
11110 Los Alamitos Blvd
Los Alamitos, CA 90720-3602
Phone
(562) 380-1376
NPI assigned
Jun 14, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2021

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

Authorized official

Name
Maria Virgen Elias, LCSWNPI 1932585973
Title
Director
Phone
(562) 380-1376

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

11110 Los Alamitos Blvd
Los Alamitos, CA 90720-3602

Mailing address

6475 E Pacific Coast Hwy # 418
Long Beach, CA 90803-4201

National Provider Directory

National Provider Directory

Locations

11110 Los Alamitos Blvd
Los Alamitos, CA 90720
Phone (562) 380-1376

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1623628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623628800000",
    "number": "1407424609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6475 E PACIFIC COAST HWY # 418",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908034201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11110 LOS ALAMITOS BLVD",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907203602",
            "telephone_number": "562-380-1376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMAVERA COUNSELING LICENSED CLINICAL SOCIAL WORKER CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-14",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-12",
        "status": "A",
        "authorized_official_last_name": "VIRGEN ELIAS",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "562-380-1376",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Alamitos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2021; 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.