Active NPI
Belverly Sue Nallsdemar, L.C.S.W.
- Clinical Social Worker
- Garden Grove, CA
National Provider Identifier
1457524423
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS 14453
- Practice address
- 12881 Fern St
#D
Garden Grove, CA 92841-4331 - Phone
- (714) 615-5252
- Fax
- (714) 622-4806
- NPI assigned
- Apr 10, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCS 14453 | CA | Primary |
Addresses
Primary practice location
12881 Fern St
#D
Garden Grove, CA 92841-4331
Mailing address
12881 Fern St
#D
Garden Grove, CA 92841-4331
Phone (714) 615-5252
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCS 14453 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207785600000",
"number": "1457524423",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12881 FERN ST",
"address_2": "#D",
"city": "GARDEN GROVE",
"state": "CA",
"postal_code": "928414331",
"telephone_number": "714-615-5252",
"fax_number": "714-622-4806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12881 FERN ST",
"address_2": "#D",
"city": "GARDEN GROVE",
"state": "CA",
"postal_code": "928414331",
"telephone_number": "714-615-5252",
"fax_number": "714-622-4806"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NALLSDEMAR",
"first_name": "BELVERLY",
"middle_name": "SUE",
"name_prefix": "Ms.",
"credential": "L.C.S.W.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-04-10",
"last_updated": "2008-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS 14453",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Garden Grove, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.