Individual provider Active NPI

Mary A Naimie, LCSW

  • Clinical Social Worker
  • San Clemente, CA
National Provider Identifier
1487749115
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS16955 Issued in CA
Practice address
1238 Puerta del Sol
San Clemente, CA 92673-6310
Phone
(949) 234-1120
NPI assigned
Oct 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LCS16955 CA
Clinical Social Worker 1041C0700X LCS16955 CA Primary
Clinical Social Worker 1041C0700X 8887-C NV

Addresses

Primary practice location

1238 Puerta del Sol
San Clemente, CA 92673-6310

Mailing address

1238 Puerta del Sol
San Clemente, CA 92673-6310
Phone (949) 234-1120

Other identifiers 1

IdentifierTypeStateIssuer
800003344OtherRR MEDICARE

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

LicenseStateTypeSpecialty
LCS16955CAMDClinical Social Worker
8887-CNVMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Naimie LCSW, Inc Mental Health CurrentSince Oct 27, 2024 Accepting new patients

Locations

1238 Puerta del Sol
San Clemente, CA 92673
Phone (949) 234-1120

Organizations & group practices 1

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1487749115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1238 PUERTA DEL SOL",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926736310",
            "telephone_number": "949-234-1120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1238 PUERTA DEL SOL",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926736310",
            "telephone_number": "949-234-1120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAIMIE",
        "first_name": "MARY",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "LCS16955",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS16955",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "8887-C",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "800003344",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Clemente, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.