Active NPI
Robert Jack Verwys, LCSW
- Clinical Social Worker
- Long Beach, CA
National Provider Identifier
1598212938
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 88902
- Practice address
- 1301 Pine Ave
Long Beach, CA 90813-3124 - Phone
- (562) 595-1159
- Fax
- (562) 486-4661
- NPI assigned
- Sep 1, 2016
- Sex
- Male
- Sole proprietor
- No
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 | 88902 | CA | Primary |
Addresses
Primary practice location
1301 Pine Ave
Long Beach, CA 90813-3124
Mailing address
1301 Pine Ave
Long Beach, CA 90813-3124
Phone (562) 595-1159
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
| License | State | Type | Specialty |
|---|---|---|---|
| 88902 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Octave Behavioral Health PC | 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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557792000000",
"number": "1598212938",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1301 PINE AVE",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908133124",
"telephone_number": "562-595-1159",
"fax_number": "562-486-4661"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 PINE AVE",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908133124",
"telephone_number": "562-595-1159",
"fax_number": "562-486-4661"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VERWYS",
"first_name": "ROBERT",
"middle_name": "JACK",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-09-01",
"last_updated": "2019-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "88902",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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.