Organization Active NPI

Rebecca Danelski Licensed Clinical Social Worker, Inc.

  • Clinical Social Worker
  • Culver City, CA
National Provider Identifier
1659986214
Registry record updated Sep 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
REBECCA DANELSKI LICENSED CLINICAL SOCIAL WORKER, INC.
Practice address
10811 Washington Blvd Ste 280
Culver City, CA 90232-3653
Phone
(310) 876-4052
Fax
(310) 876-4052
NPI assigned
Sep 10, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2020

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

Authorized official

Name
Rebecca Jeanne Danelski, MSWNPI 1730308263
Title
President
Phone
(310) 629-0400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

10811 Washington Blvd Ste 280
Culver City, CA 90232-3653

Mailing address

10811 Washington Blvd Ste 280
Culver City, CA 90232-3653
Phone (310) 876-4052

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201023002626 CA Part B Supplier - Clinic/Group Practice 6709206188 Receives reassigned benefits from 1 practitioner
Practice locations: Culver City, CA

National Provider Directory

National Provider Directory

Locations

10811 Washington Blvd
Ste 280
Culver City, CA 90232
Phone (310) 629-0400

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1599696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599696000000",
    "number": "1659986214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10811 WASHINGTON BLVD STE 280",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902323653",
            "telephone_number": "310-876-4052",
            "fax_number": "310-876-4052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10811 WASHINGTON BLVD STE 280",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902323653",
            "telephone_number": "310-876-4052",
            "fax_number": "310-876-4052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REBECCA DANELSKI LICENSED CLINICAL SOCIAL WORKER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-10",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-10",
        "status": "A",
        "authorized_official_last_name": "DANELSKI",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "JEANNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-629-0400",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Culver City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.