Individual provider Active NPI

Mayra P Maciel

  • Clinical Social Worker
  • Torrance, CA
National Provider Identifier
1558775098
Registry record updated Sep 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW88704 Issued in CA
Practice address
21081 S Western Ave Ste 295
Torrance, CA 90501
Phone
(310) 533-6600
NPI assigned
Jun 12, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X ASW67242 CA
Clinical Social Worker 1041C0700X LCSW88704 CA Primary

Addresses

Primary practice location

21081 S Western Ave Ste 295
Torrance, CA 90501

Mailing address

21081 S Western Ave Ste 295
Torrance, CA 90501-1707
Phone (310) 533-6600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
ASW67242CAMDClinical Social Worker
LCSW88704CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles County Department of Mental Health Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1402531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568160000000",
    "number": "1558775098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21081 S WESTERN AVE STE 295",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905011707",
            "telephone_number": "310-533-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21081 S WESTERN AVE STE 295",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "90501",
            "telephone_number": "310-533-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACIEL",
        "first_name": "MAYRA",
        "middle_name": "P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-12",
        "last_updated": "2019-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW67242",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW88704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.