Individual provider Active NPI

Brett Allen McGillivray, LCSW

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1669512737
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS 23132 Issued in CA
Practice address
5000 W Sunset Blvd
4TH Floor
Los Angeles, CA 90027-5861
Phone
(323) 669-2153
NPI assigned
Feb 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 LCS 23132 CA Primary

Addresses

Primary practice location

5000 W Sunset Blvd
4TH Floor
Los Angeles, CA 90027-5861

Mailing address

200 McNeil LN
#210
Newport Beach, CA 92663-2698
Phone (949) 338-3005

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

LicenseStateTypeSpecialty
LCS 23132CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669512737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MCNEIL LN",
            "address_2": "#210",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926632698",
            "telephone_number": "949-338-3005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 W SUNSET BLVD",
            "address_2": "4TH FLOOR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900275861",
            "telephone_number": "323-669-2153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGILLIVRAY",
        "first_name": "BRETT",
        "middle_name": "ALLEN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 23132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.