Active NPI
Kevin A. McGeoch, LCSW
- Clinical Social Worker
- Lakeport, CA
National Provider Identifier
1629528484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 95098
- Practice address
- 572 Lakeport Blvd
Lakeport, CA 95453-5420 - Phone
- (707) 245-5582
- NPI assigned
- Oct 5, 2016
- Reactivated
- Jun 25, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 95098 | CA | Primary |
Addresses
Primary practice location
572 Lakeport Blvd
Lakeport, CA 95453-5420
Mailing address
PO Box 102
Lakeport, CA 95453-0102
Phone (707) 245-5582
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 |
|---|---|---|---|
| 95098 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1475625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593043200000",
"number": "1629528484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 102",
"city": "LAKEPORT",
"state": "CA",
"postal_code": "954530102",
"telephone_number": "707-245-5582"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "572 LAKEPORT BLVD",
"city": "LAKEPORT",
"state": "CA",
"postal_code": "954535420",
"telephone_number": "707-245-5582"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCGEOCH",
"first_name": "KEVIN",
"middle_name": "A.",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-10-05",
"last_updated": "2020-06-25",
"certification_date": "2020-06-25",
"deactivation_date": "2020-06-19",
"reactivation_date": "2020-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "95098",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakeport, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.