Jodie Dianne Ross Mordaunt, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

18806 Issued in CA

Practice address

104 Walnut Ave Ste 208
Santa Cruz, CA 95060

Phone

(831) 423-9444

NPI assigned

Apr 20, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Foresight Mental HealthGroup PAC ID 6103176219, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jodie.ross.mordaunt.1@25119.direct.athenahealth.com

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.

• Foresight Mental Health

  • Counselor
  • Sacramento, CA
  • NPI 1902390537

  Clinical

  Medicare reassignment Care Compare group NPD
• Family Service Agency of the Central Coast

  • Mental Health Counselor
  • Santa Cruz, CA
  • NPI 1104994136
  Medicare reassignment NPD

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

{
    "created_epoch": "1524182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536105600000",
    "number": "1528555919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 WALNUT AVE STE 208",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950603929",
            "telephone_number": "831-423-9444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 WALNUT AVE STE 208",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "95060",
            "telephone_number": "831-423-9444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2901 Park Ave Ste A3",
            "address_purpose": "LOCATION",
            "city": "Soquel",
            "state": "CA",
            "postal_code": "950732831",
            "country_code": "US",
            "telephone_number": "831-423-9444",
            "fax_number": "831-423-1532",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSS MORDAUNT",
        "first_name": "JODIE",
        "middle_name": "DIANNE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-20",
        "last_updated": "2018-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "18806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Rosen, MFT INTERN
• Mark Andrew Rosen, M.D.
• Robert Rosen
• Lawrence Rosenbaum, M.D.
• Edwin Rosenfeld
• Anthony William Ross
• Bruce Lambert Ross, LMFT
• Crystal Ross
• Isabelle Bianca Ross
• John Malachi Ross

• Clinical Social Worker in Santa Cruz, CA
• Providers in Santa Cruz, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2018; 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.

Verify at the official NPI Registry.