Active NPI
John Derrick Monfort, LCSW
- Clinical Social Worker
- Arcata, CA
National Provider Identifier
1639497720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 28973
- Practice address
- 785 18TH St
Arcata, CA 95521-5683 - Phone
- (707) 822-2481
- Fax
- (707) 822-3656
- NPI assigned
- May 13, 2010
- Sex
- Male
- Sole proprietor
- No
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 | 28973 | CA | Primary |
Addresses
Primary practice location
785 18TH St
Arcata, CA 95521-5683
Mailing address
670 9TH Street
Suite 203
Arcata, CA 95521-6249
Phone (707) 826-8633
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 |
|---|---|---|---|
| 28973 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1273708800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1402876800000",
"number": "1639497720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "670 9TH STREET",
"address_2": "SUITE 203",
"city": "ARCATA",
"state": "CA",
"postal_code": "955216249",
"telephone_number": "707-826-8633",
"fax_number": "707-826-8638"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "785 18TH ST",
"city": "ARCATA",
"state": "CA",
"postal_code": "955215683",
"telephone_number": "707-822-2481",
"fax_number": "707-822-3656"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONFORT",
"first_name": "JOHN",
"middle_name": "DERRICK",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-05-13",
"last_updated": "2014-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "28973",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Arcata, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.