Annemarie Winic
Individual provider Active NPI Clinical Social Worker · Santa Monica, CA
NPI 1487782959 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1487782959
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- LCS20740 (CA)
- Practice address
- 1339 20TH St
Santa Monica, CA 90404-2033 - Phone
- (310) 829-8586
- Fax
- (310) 829-8455
- NPI assigned
- Feb 28, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Family Psychological Services Inc
Practice addresses (Care Compare)
30495 Canwood St
Suite 101
Agoura Hills, CA 91301-4331
Phone (818) 707-7366
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201006000709 | CA | Practitioner - Clinical Social Worker | 2860811197 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20740 | CA | MD | Clinical Psychologist |
| LCS20740 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Psychological Services Inc | Current |
Accepting new patients |
Locations
30495 Canwood St
Ste 101
Agoura Hills, CA 91301
Phone (818) 707-7366
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCS20740 | CA | Yes |
Addresses
Primary practice location
1339 20TH St
Santa Monica, CA 90404-2033
Mailing address
1339 20TH St
Santa Monica, CA 90404-2033
Other providers in Santa Monica, CA
- Timothy Wilson
- Chitra Wiltshire
- Kristin Wimp
- Joseph Windheim
- Haley Angelou Winer
- Arenda Winiecki
- Janet Winikoff
- Virginia/Ginny Leland Winn
- Deborah Campana Winstead
- Robert A Winters
All providers in Santa Monica, CA · Clinical Social Worker in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.