Individual provider Active NPI

Mary Senchyna, LCSW

  • Clinical Social Worker
  • Fairfield, CA
National Provider Identifier
1518153568
Registry record updated Sep 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS 20565 Issued in CA
Practice address
2101 Courage Dr
Fairfield, CA 94533-6717
Phone
(707) 784-2140
NPI assigned
Sep 23, 2007
Last updated
Sep 23, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2007

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 LCS 20565 CA Primary

Addresses

Primary practice location

2101 Courage Dr
Fairfield, CA 94533-6717

Mailing address

2101 Courage Dr
Fairfield, CA 94533-6717
Phone (707) 784-2140

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140312001454 CA Practitioner - Clinical Social Worker 3274763289 Practice locations: Oakland, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Oakland, CA 94608
Phone (510) 435-4384

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS 20565CAMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1190505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190505600000",
    "number": "1518153568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 COURAGE DR",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945336717",
            "telephone_number": "707-784-2140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 COURAGE DR",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945336717",
            "telephone_number": "707-784-2140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SENCHYNA",
        "first_name": "MARY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-23",
        "last_updated": "2007-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 20565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

Verify at the official NPI Registry.