Active NPI
Joseph Stephen McConico, MSW, LCSW
- Clinical Social Worker
- San Diego, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW96008
- Practice address
- 591 Camino de la Reina Ste 210
San Diego, CA 92108-3104 - Phone
- (619) 206-5271
- Fax
- (619) 795-3274
- NPI assigned
- Aug 25, 2020
- Last updated
- Feb 17, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | C009649 | NC | |
| Clinical Social Worker | 1041C0700X | LCSW96008 | CA | Primary |
Addresses
Primary practice location
591 Camino de la Reina Ste 210
San Diego, CA 92108-3104
Mailing address
3952D Clairemont Mesa Blvd # 452
San Diego, CA 92117-2714
Phone (704) 608-9379
Other practice location 1
5274 Mount Alifan Dr
San Diego, CA 92111-2621
Phone (704) 608-9379
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 |
|---|---|---|---|
| LCSW96008 | CA | MD | Clinical Social Worker |
| C009649 | NC | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Khachatryan Corporation, Licensed Professional Clinical Counselor | Current | Accepting new patients |
Locations
591 Camino de la Reina
Ste 210
San Diego, CA 92108
Phone (619) 206-5271
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Healthy Minds Counseling Services
- Counselor
- San Diego, CA
- NPI 1437626488
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598313600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613520000000",
"number": "1619580057",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3952D CLAIREMONT MESA BLVD # 452",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921172714",
"telephone_number": "704-608-9379"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "591 CAMINO DE LA REINA STE 210",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921083104",
"telephone_number": "619-206-5271",
"fax_number": "619-795-3274"
}
],
"practiceLocations": [
{
"address_1": "5274 Mount Alifan Dr",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921112621",
"country_code": "US",
"telephone_number": "704-608-9379",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCCONICO",
"first_name": "JOSEPH",
"middle_name": "STEPHEN",
"credential": "MSW, LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-08-25",
"last_updated": "2021-02-17",
"certification_date": "2021-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "C009649",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCSW96008",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.