Individual provider Active NPI

Cecilia I McPherson, L.C.S.W.

  • Clinical Social Worker
  • San Andreas, CA
National Provider Identifier
1558733972
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW 67593 Issued in CA
Practice address
23 W St Charles St
San Andreas, CA 95249
Phone
(209) 419-0167
Fax
(888) 707-2984
NPI assigned
Oct 25, 2015
Last updated
Mar 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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 LCSW 67593 CA Primary

Addresses

Primary practice location

23 W St Charles St
San Andreas, CA 95249

Mailing address

PO Box 5153
Bear Valley, CA 95223-5153
Phone (209) 419-0167

Other practice location 1

1113 Highway 49
San Andreas, CA 95249-9583
Phone (209) 755-1400

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
I20151216001427 CA Practitioner - Clinical Social Worker 3870893050 Reassigns benefits to 1 organization
Practice locations: San Andreas, CA; Valley Springs, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mark Twain Medical CenterGroup PAC ID 8820073711, 27 clinicians

Practice addresses (Care Compare)

590 Stanislaus Ave
Angels Camp, CA 95222-9355
Phone (209) 736-0813

768 Mountain Ranch Rd
San Andreas, CA 95249-9707
Phone (209) 754-3521

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW 67593CAMDClinical Social Worker
67593CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Mark Twain Medical Center CurrentSince Aug 4, 2022 Accepting new patients

Locations

12140 New York Ranch Rd
Jackson, CA 95642
Phone (209) 257-2400

768 Mountain Ranch Rd
San Andreas, CA 95249
Phone (209) 464-6422

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, 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": "1445731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1558733972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5153",
            "city": "BEAR VALLEY",
            "state": "CA",
            "postal_code": "952235153",
            "telephone_number": "209-419-0167",
            "fax_number": "888-707-2984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 W ST CHARLES ST",
            "city": "SAN ANDREAS",
            "state": "CA",
            "postal_code": "95249",
            "telephone_number": "209-419-0167",
            "fax_number": "888-707-2984"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1113 Highway 49",
            "address_purpose": "LOCATION",
            "city": "San Andreas",
            "state": "CA",
            "postal_code": "952499583",
            "country_code": "US",
            "telephone_number": "209-755-1400",
            "fax_number": "209-755-1430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCPHERSON",
        "first_name": "CECILIA",
        "middle_name": "I",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-25",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW 67593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Andreas, CA

Sources for this page

Verify at the official NPI Registry.