Active NPI
Spencer Seidman, LCSW
- Clinical Social Worker
- Berkeley, CA
National Provider Identifier
1568914885
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 17699
- Practice address
- 2006 Dwight Way
Suite 201
Berkeley, CA 94704-2633 - Phone
- (510) 984-3514
- Fax
- (415) 681-6908
- NPI assigned
- Nov 3, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 17699 | CA | Primary |
Addresses
Primary practice location
2006 Dwight Way
Suite 201
Berkeley, CA 94704-2633
Mailing address
2006 Dwight Way
Suite 201
Berkeley, CA 94704-2633
Phone (510) 984-3514
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17699 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1478131200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478131200000",
"number": "1568914885",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2006 DWIGHT WAY",
"address_2": "SUITE 201",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947042633",
"telephone_number": "510-984-3514",
"fax_number": "415-681-6908"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2006 DWIGHT WAY",
"address_2": "SUITE 201",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947042633",
"telephone_number": "510-984-3514",
"fax_number": "415-681-6908"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEIDMAN",
"first_name": "SPENCER",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-11-03",
"last_updated": "2016-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "17699",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Berkeley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.