Individual provider Active NPI

Cara Rose Michalek, LPCC

  • Professional Counselor
  • San Diego, CA
National Provider Identifier
1609396290
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
16028 Issued in CA
Practice address
2136 El Cajon Blvd
San Diego, CA 92104-1102
Phone
(619) 515-2588
NPI assigned
Jun 23, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X PPC-1009 WY
Professional Counselor 101YP2500X 16028 CA Primary

Addresses

Primary practice location

2136 El Cajon Blvd
San Diego, CA 92104-1102

Mailing address

PO Box 376
Afton, WY 83110-0376

Other practice location 1

PO Box 376
Afton, WY 83110-0376
Phone (307) 885-9883

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
I20250206000985 CA Practitioner - Mental Health Counselor 3173053105 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PPC-1009WYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers of San Diego, Inc Current Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Nov 21, 2024 Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Nov 21, 2024 Accepting new patients

Locations

2136 El Cajon Blvd
San Diego, CA 92104
Phone (619) 515-2588

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

Organizations & group practices 3

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": "1498176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1609396290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 376",
            "city": "AFTON",
            "state": "WY",
            "postal_code": "831100376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2136 EL CAJON BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921041102",
            "telephone_number": "619-515-2588"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "PO Box 376",
            "address_purpose": "LOCATION",
            "city": "Afton",
            "state": "WY",
            "postal_code": "831100376",
            "country_code": "US",
            "telephone_number": "307-885-9883",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MICHALEK",
        "first_name": "CARA",
        "middle_name": "ROSE",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-23",
        "last_updated": "2024-08-06",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WY",
            "license": "PPC-1009",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "16028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.