Individual provider Active NPI

Cherrise L Elijah, LCSW

  • Clinical Social Worker
  • Hawthorne, CA
National Provider Identifier
1457879744
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW104292 Issued in CA
Practice address
PO Box 1158
Hawthorne, CA 90251-1158
Phone
(424) 262-1983
NPI assigned
Sep 6, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X LCSW104292 CA
Clinical Social Worker 1041C0700X LCSW104292 CA Primary

Addresses

Primary practice location

PO Box 1158
Hawthorne, CA 90251-1158

Mailing address

12204 Cedar Ave
Hawthorne, CA 90250-4043
Phone (310) 629-8694

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
I20240207002718 CA Practitioner - Clinical Social Worker 8426491390 Reassigns benefits to 3 organizations
Practice locations: Hawthorne, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW104292CAMDSocial Worker
104292CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Sud Specialty Group - Ca Clinical CurrentSince Jun 1, 2025 Accepting new patients
Grow Healthcare Group PC Mental Health CurrentSince Oct 21, 2025 Accepting new patients
Concertocare Medical Group of California, P.C. CurrentSince Dec 1, 2023 Accepting new patients

Locations

7677 Center Ave
Ste 214
Huntington Beach, CA 92647
Phone (310) 433-9507

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

4633 Old Ironsides Dr
Ste 304
Santa Clara, CA 95054
Phone (501) 271-9428

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

811 Main St
#7
Kansas City, MO 64105

Organizations & group practices 3

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": "1504656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1457879744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12204 CEDAR AVE",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902504043",
            "telephone_number": "310-629-8694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 1158",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902511158",
            "telephone_number": "424-262-1983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELIJAH",
        "first_name": "CHERRISE",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-06",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "LCSW104292",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW104292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawthorne, CA

Sources for this page

Verify at the official NPI Registry.