Kassandra Bennett Edwards, LCSW, MFT

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCS13017 Issued in CA

Practice address

511 Parrott Drive San Mateo
San Mateo, CA 94402-9440

Phone

(650) 340-8866

Fax

(650) 742-7105

NPI assigned

Nov 30, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604620800000",
    "number": "1578630745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 PARROTT DRIVE SAN MATEO",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944023048",
            "telephone_number": "650-340-8866",
            "fax_number": "650-742-7135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 PARROTT DRIVE SAN MATEO",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944029440",
            "telephone_number": "650-340-8866",
            "fax_number": "650-742-7105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "KASSANDRA",
        "middle_name": "BENNETT",
        "name_prefix": "Ms.",
        "credential": "LCSW, MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW13017",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS13017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edgewood Center for Children and Families
• Melissa Arabian Edling
• Jacatherine Sarean Edmond
• Eds Center, LP
• Ann G Edwards, MFT
• Lynn Marie Edwards, D.D.S.
• Thomas Anthony Ryle Egan
• Rayana Egea, LMFT
• Bryan Matthew Eglesia
• Autumn Dawn Eglitis, M.D.

• Clinical Social Worker in San Mateo, CA
• Providers in San Mateo, 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 Nov 6, 2020; 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.