Individual provider Active NPI

Kristin Louise Manuel, LCSW

  • Clinical Social Worker
  • Sacramento, CA
National Provider Identifier
1437387784
Registry record updated Jun 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW60824 Issued in CA
Practice address
2801 K St Ste 240
Sacramento, CA 95816-5170
Phone
(916) 887-4660
NPI assigned
Jun 25, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2021

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 53052 TX
Clinical Social Worker 1041C0700X LCSW60824 CA Primary

Addresses

Primary practice location

2801 K St Ste 240
Sacramento, CA 95816-5170

Mailing address

PO Box 255228
Sacramento, CA 95865-5228
Phone (916) 708-8083

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
I20210610003316 CA Practitioner - Clinical Social Worker 1052574092 Practice locations: Elk Grove, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

8788 Elk Grove Blvd
BLDG 3 Suite 12a
Elk Grove, CA 95624-1766
Phone (916) 399-3144

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
60824CAMDAddiction (Substance Use Disorder) Counselor
LCSW60824CAMDClinical Social Worker
53052TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Austin Travis County Mental Health and Mental Retardation Center Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1245888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1437387784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 255228",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958655228",
            "telephone_number": "916-708-8083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 K ST STE 240",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165170",
            "telephone_number": "916-887-4660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANUEL",
        "first_name": "KRISTIN",
        "middle_name": "LOUISE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-25",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "53052",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW60824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.