Active NPI
Cynthia Y Corrales, LCSW
- Clinical Social Worker
- Los Angeles, CA
National Provider Identifier
1467979575
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW110463
- Practice address
- 520 S. Lafayette Park Place 3Rd Floor
Los Angeles, CA 90057 - Phone
- (213) 252-2100
- Fax
- (213) 252-2199
- NPI assigned
- Aug 29, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 84491 | CA | |
| Rehabilitation Practitioner | 225400000X | |||
| Clinical Social Worker | 1041C0700X | LCSW110463 | CA | Primary |
Addresses
Primary practice location
520 S. Lafayette Park Place 3Rd Floor
Los Angeles, CA 90057
Mailing address
3112 Folsom St
Los Angeles, CA 90063-2826
Phone (323) 428-9741
Other names 1
- Cynthia Ortiz
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
520 S Lafayette Park PL
FL 3
Los Angeles, CA 90057-5400
Phone (213) 252-2100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 84491 | CA | MD | Mental Health Counselor |
| LCSW110463 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Special Service for Groups, Inc. | Current | Accepting new patients | |
| Special Service for Groups, Inc. | Current | Accepting new patients |
Locations
905 E 8th St
Los Angeles, CA 90021
Phone (213) 553-1800
Organizations & group practices 2
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.
-
- Voluntary or Charitable Agency
- Los Angeles, CA
- NPI 1952442949
-
- Community/Behavioral Health Agency
- Los Angeles, CA
- NPI 1013404524
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664755200000",
"number": "1467979575",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3112 FOLSOM ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900632826",
"telephone_number": "323-428-9741",
"fax_number": "323-428-9741"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "520 S. LAFAYETTE PARK PLACE 3RD FLOOR",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90057",
"telephone_number": "213-252-2100",
"fax_number": "213-252-2199"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORRALES",
"first_name": "CYNTHIA",
"middle_name": "Y",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-29",
"last_updated": "2022-10-03",
"certification_date": "2022-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "84491",
"primary": false
},
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCSW110463",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CYNTHIA",
"last_name": "ORTIZ",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.