Individual provider Active NPI

Rachel Marine, LCSW

  • Clinical Social Worker
  • West Sacramento, CA
National Provider Identifier
1619556883
Registry record updated Apr 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW100513 Issued in CA
Practice address
817 Todhunter Ave
West Sacramento, CA 95605-2255
Phone
(954) 295-0191
NPI assigned
Apr 5, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW100513 CA Primary

Addresses

Primary practice location

817 Todhunter Ave
West Sacramento, CA 95605-2255

Mailing address

817 Todhunter Ave
West Sacramento, CA 95605-2255
Phone (954) 295-0191

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240127000015 FL Practitioner - Clinical Social Worker 2961855804 Reassigns benefits to 1 organization
I20240208002550 CA Practitioner - Clinical Social Worker 2961855804 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW100513CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Clinical CurrentSince Dec 26, 2023 Accepting new patients
Grow Healthcare Group PC Clinical CurrentSince Jan 5, 2024 Accepting new patients

Locations

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 2

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": "1617580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617580800000",
    "number": "1619556883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 TODHUNTER AVE",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956052255",
            "telephone_number": "954-295-0191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 TODHUNTER AVE",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956052255",
            "telephone_number": "954-295-0191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARINE",
        "first_name": "RACHEL",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-05",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW100513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Sacramento, CA

Sources for this page

Verify at the official NPI Registry.