Active NPI
Rebecca Porteous, LCSW
- Clinical Social Worker
- McKinleyville, CA
National Provider Identifier
1659562791
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS18459
- Practice address
- 3135 Boeing Ave Ste A1
McKinleyville, CA 95519-9373 - Phone
- (707) 633-6145
- Fax
- (707) 633-6128
- NPI assigned
- Aug 5, 2007
- Sex
- Female
- 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 | LCS18459 | CA | Primary |
Addresses
Primary practice location
3135 Boeing Ave Ste A1
McKinleyville, CA 95519-9373
Mailing address
PO Box 992
Arcata, CA 95518-0992
Phone (707) 822-1496
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCS18459 | CA | MD | Clinical Social Worker |
| 18459 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1394409600000",
"number": "1659562791",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 992",
"city": "ARCATA",
"state": "CA",
"postal_code": "955180992",
"telephone_number": "707-822-1496",
"fax_number": "707-822-1406"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3135 BOEING AVE STE A1",
"city": "MCKINLEYVILLE",
"state": "CA",
"postal_code": "955199373",
"telephone_number": "707-633-6145",
"fax_number": "707-633-6128"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PORTEOUS",
"first_name": "REBECCA",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-08-05",
"last_updated": "2014-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS18459",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in McKinleyville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 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.