Individual provider Active NPI

Micheal Weuste, LCSW

  • Clinical Social Worker
  • Escondido, CA
National Provider Identifier
1417143207
Registry record updated Dec 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
84945 Issued in CA
Practice address
1520 S Escondido Blvd
Escondido, CA 92025-6017
Phone
(760) 871-2020
Fax
(760) 489-1321
NPI assigned
Sep 14, 2007
Last updated
Dec 19, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149-003769 IL
Clinical Social Worker 1041C0700X 84945 CA Primary

Addresses

Primary practice location

1520 S Escondido Blvd
Escondido, CA 92025-6017

Mailing address

1520 S Escondido Blvd
Escondido, CA 92025-6017
Phone (760) 871-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149-003769ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Exodus Recovery, Inc. CurrentSince Jan 1, 2020 Accepting new patients
Exodus Recovery Inc Current Accepting new patients

Locations

9808 Venice Blvd
Ste 700
Culver City, CA 90232
Phone (310) 253-9494

4308 30th St
San Diego, CA 92104

Organizations & group practices 2

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": "1189728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576713600000",
    "number": "1417143207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 S ESCONDIDO BLVD",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920256017",
            "telephone_number": "760-871-2020",
            "fax_number": "760-489-1321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 S ESCONDIDO BLVD",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920256017",
            "telephone_number": "760-871-2020",
            "fax_number": "760-489-1321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEUSTE",
        "first_name": "MICHEAL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-14",
        "last_updated": "2019-12-19",
        "certification_date": "2019-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149-003769",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "84945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Escondido, CA

Sources for this page

Verify at the official NPI Registry.