Individual provider Active NPI

Constance A Collins, LCSW

  • Clinical Social Worker
  • Escondido, CA
National Provider Identifier
1477600195
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS23330 Issued in CA
Practice address
135 W Mission Ave Ste 111C
Escondido, CA 92025-1718
Phone
(760) 518-0001
NPI assigned
Jan 4, 2007
Last updated
Jul 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCS23330 CA Primary

Addresses

Primary practice location

135 W Mission Ave Ste 111C
Escondido, CA 92025-1718

Mailing address

PO Box 300334
Escondido, CA 92030-0334
Phone (760) 518-0001

Other identifiers 1

IdentifierTypeStateIssuer
LCS23330OtherCALICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20180522000198 TX Practitioner - Clinical Social Worker 9739288515 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fort Bidwell Indian CommunityGroup PAC ID 5890960355, 3 clinicians

Practice addresses (Care Compare)

132 Mee Thee-Uh Rd
Fort Bidwell, CA 96112-0247
Phone (530) 279-6194

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS23330CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
San Diego American Indian Health Center CurrentSince Jul 11, 2011 Accepting new patients
Stepping Stone of San Diego, Inc. Past Accepting new patients
Glory Health Network PastSince Oct 19, 2020 Accepting new patients

Locations

2602 1st Ave
Ste 105
San Diego, CA 92103

2630 1st Ave
San Diego, CA 92103
Phone (619) 234-2158

Interoperability endpoints

  • Direct secure messaging: connie.collins.p1@direct.scihp.nextgenshare.com
  • Direct secure messaging: constance.collins.p1@direct.warnermountainihp.nextgenshare.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/IFGCCD

Organizations & group practices 4

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": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1477600195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 300334",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920300334",
            "telephone_number": "760-518-0001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 W MISSION AVE STE 111C",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920251718",
            "telephone_number": "760-518-0001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "CONSTANCE",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS23330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "LCS23330",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Escondido, CA

Sources for this page

Verify at the official NPI Registry.