NPIMap

Individual provider Active NPI

Shirley Summers, LCSW

  • Clinical Social Worker
  • Gardena, CA
National Provider Identifier
1467891655
Registry record updated Oct 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS28873 Issued in CA
Practice address
15519 Crenshaw Blvd
Gardena, CA 90249-4525
Phone
(310) 679-9126
Fax
(310) 679-7124
NPI assigned
Jun 20, 2013
Last updated
Oct 15, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LCS 28873 CA
Clinical Social Worker 1041C0700X LCS28873 CA Primary

Addresses

Primary practice location

15519 Crenshaw Blvd
Gardena, CA 90249-4525

Mailing address

15519 Crenshaw Blvd
Gardena, CA 90249-4525
Phone (310) 679-9126

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231110002455 CA Practitioner - Clinical Social Worker 9234293663 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS 28873CAMDAddiction (Substance Use Disorder) Counselor
LCS28873CAMDClinical Social Worker
28873CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PC Clinical CurrentSince Oct 11, 2023 Accepting new patients
Los Angeles County Department of Public Health Current Accepting new patients
Sud Specialty Group - Ca Addiction (Substance Use Disorder) CurrentSince Aug 1, 2025 Accepting new patients

Locations

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

Interoperability endpoints

  • Direct secure messaging: shirleysummers-bhs-inc@lacsapc.netsmartdirect.net

Ownership & related parties

All facility ownership & control disclosures 6

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Behavioral Health Services - Family Health CenterHawthorne, CA, CCN 751903 Federally qualified health center Corporate Officer May 29, 2014
BHS-El Puerto Health CenterWilmington, CA, CCN 921971 Federally qualified health center Corporate Officer Aug 1, 2014
BHS Carson Health CenterCarson, CA, CCN A01012 Federally qualified health center Corporate Officer Aug 1, 2014
BHS Adelante Health CenterSanta Ana, CA, CCN 921970 Federally qualified health center Corporate Officer Aug 1, 2014
BHS Nuestra Health CenterLos Angeles, CA, CCN 921980 Federally qualified health center Corporate Officer Aug 1, 2014
BHS Health Center for WomenHawthorne, CA, CCN A01093 Federally qualified health center Corporate Officer Aug 1, 2014

Owned or controlled facilities with NPI records 6

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 12

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": "1371686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381795200000",
    "number": "1467891655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15519 CRENSHAW BLVD",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902494525",
            "telephone_number": "310-679-9126",
            "fax_number": "310-679-7124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15519 CRENSHAW BLVD",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902494525",
            "telephone_number": "310-679-9126",
            "fax_number": "310-679-7124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMMERS",
        "first_name": "SHIRLEY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-20",
        "last_updated": "2013-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "LCS 28873",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS28873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardena, CA

Sources for this page

Verify at the official NPI Registry.