Brandy Shavon Mays-Cancino, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

126644 Issued in CA

Practice address

31772 Casino Dr Ste B
Lake Elsinore, CA 92530-4502

Phone

(951) 459-6227

NPI assigned

Jul 10, 2014

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Foresight Mental Health

  • Counselor
  • Sacramento, CA
  • NPI 1902390537

  Clinical

  NPD (past)

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

{
    "created_epoch": "1404950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1629484605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29965 BERRYESSA DR",
            "city": "SUN CITY",
            "state": "CA",
            "postal_code": "925853510",
            "telephone_number": "805-377-1951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31772 CASINO DR STE B",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925304502",
            "telephone_number": "951-459-6227"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "29965 Berryessa Dr",
            "address_purpose": "LOCATION",
            "city": "Menifee",
            "state": "CA",
            "postal_code": "925853510",
            "country_code": "US",
            "telephone_number": "805-377-1951",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAYS-CANCINO",
        "first_name": "BRANDY",
        "middle_name": "SHAVON",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-10",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "126644",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "103573",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roxanne Martinez
• La'Shanae Annette Mason
• Marsha Diane Mathews, M.F.T.
• Demestrice Sherise Mathis V, LVN
• Cesar Augusto Mavila, D.C.
• Gail Ann MC Cabe, LCSW
• Steve McCain
• Tammy B McCamish-Hamen, MFT
• Kelly McCarroll, BS, MS, CF-SLP
• Eric McCoy, CATC II

• Clinical Social Worker in Lake Elsinore, CA
• Providers in Lake Elsinore, 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 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.