Individual provider Active NPI

Maureen Costello Orphanos, LCSW

  • Clinical Social Worker
  • Fremont, CA
National Provider Identifier
1437287646
Registry record updated Oct 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS18754 Issued in CA
Practice address
39155 Liberty St Ste G710
Fremont, CA 94538-1525
Phone
(510) 795-2434
Fax
(510) 793-3972
NPI assigned
Mar 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2019

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 LCS18754 CA Primary

Addresses

Primary practice location

39155 Liberty St Ste G710
Fremont, CA 94538-1525

Mailing address

39155 Liberty St Ste G710
Fremont, CA 94538-1525
Phone (510) 795-2434

Other practice location 1

7200 Bancroft Ave
Suite 125A
Oakland, CA 94605-2403
Phone (510) 777-3851

Other identifiers 1

IdentifierTypeStateIssuer
LCS18754OtherCASOCIAL WORK LISCENSE

Other names 1

  • Maureen Costello Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS18754CAMDClinical Social Worker
18754CAMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571702400000",
    "number": "1437287646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39155 LIBERTY ST STE G710",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381525",
            "telephone_number": "510-795-2434",
            "fax_number": "510-793-3972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39155 LIBERTY ST STE G710",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381525",
            "telephone_number": "510-795-2434",
            "fax_number": "510-793-3972"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7200 Bancroft Ave",
            "address_2": "Suite 125A",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946052403",
            "country_code": "US",
            "telephone_number": "510-777-3851",
            "fax_number": "510-777-3806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ORPHANOS",
        "first_name": "MAUREEN",
        "middle_name": "COSTELLO",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2019-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS18754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOCIAL WORK LISCENSE",
            "identifier": "LCS18754",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAUREEN",
            "last_name": "COSTELLO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2019; 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.