Individual provider Active NPI

Heather Snow, LCSW

  • Clinical Social Worker
  • Crescent City, CA
National Provider Identifier
1548569130
Registry record updated Jan 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
86018 Issued in CA
Practice address
550 E Washington Blvd Ste 100
Crescent City, CA 95531-8161
Phone
(707) 826-8633
NPI assigned
Mar 22, 2011
Last updated
Jan 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 077442 NY
Clinical Social Worker 1041C0700X 079624 NY
Clinical Social Worker 1041C0700X 86018 CA Primary

Addresses

Primary practice location

550 E Washington Blvd Ste 100
Crescent City, CA 95531-8161

Mailing address

PO Box 275
Smith River, CA 95567-0275

Other practice location 1

1275 8th St
Arcata, CA 95521-5770
Phone (707) 826-8633

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
I20240109004594 CA Practitioner - Clinical Social Worker 1759660491 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
New York University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

550 E Washington Blvd
Crescent City, CA 95531-8160
Phone (707) 465-6925

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
079624NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Open Door Community Health Centers CurrentSince Jun 2, 2024 Accepting new patients
Open Door Community Health Centers CurrentSince Nov 13, 2023 Accepting new patients
Open Door Community Health Centers CurrentSince Nov 13, 2023 Accepting new patients

Locations

1275 8th St
Arcata, CA 95521

550 E Washington Blvd
Crescent City, CA 95531
Phone (707) 465-6925

550 E Washington Blvd
Ste 100
Crescent City, CA 95531
Phone (707) 465-6925

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Perinatal Services of Northcountry ClinicArcata, CA, CCN 551099 Federally qualified health center Corporate Director Jul 26, 2021

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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": "1300752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642723200000",
    "number": "1548569130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 275",
            "city": "SMITH RIVER",
            "state": "CA",
            "postal_code": "955670275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 E WASHINGTON BLVD STE 100",
            "city": "CRESCENT CITY",
            "state": "CA",
            "postal_code": "955318161",
            "telephone_number": "707-826-8633"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1275 8th St",
            "address_purpose": "LOCATION",
            "city": "Arcata",
            "state": "CA",
            "postal_code": "955215770",
            "country_code": "US",
            "telephone_number": "707-826-8633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SNOW",
        "first_name": "HEATHER",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-22",
        "last_updated": "2022-01-21",
        "certification_date": "2022-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NY",
            "license": "077442",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "079624",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "86018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crescent City, CA

Sources for this page

Verify at the official NPI Registry.