Individual provider Active NPI

Eden Marie Brion Neely, LCSW

  • Clinical Social Worker
  • Irvine, CA
National Provider Identifier
1659922755
Registry record updated May 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW88654 Issued in CA
Practice address
19712 Macarthur Blvd Ste 110
Irvine, CA 92612-2407
Phone
(949) 528-8197
NPI assigned
Sep 20, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW88654 CA Primary

Addresses

Primary practice location

19712 Macarthur Blvd Ste 110
Irvine, CA 92612-2407

Mailing address

19712 Macarthur Blvd Ste 110
Irvine, CA 92612-2407
Phone (949) 528-8197

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200617000720 CA Practitioner - Clinical Social Worker 5597187724 Practice locations: Irvine, CA; Newport Beach, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW88654CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Transcendent Therapy, a Psychology Corporation CurrentSince Feb 1, 2023 Accepting new patients

Locations

1151 Dove St
Ste 113
Newport Beach, CA 92660
Phone (949) 208-7334

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1568937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621814400000",
    "number": "1659922755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19712 MACARTHUR BLVD STE 110",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926122407",
            "telephone_number": "949-528-8197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19712 MACARTHUR BLVD STE 110",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926122407",
            "telephone_number": "949-528-8197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRION NEELY",
        "first_name": "EDEN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-20",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW88654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.