Individual provider Active NPI

Sharon Jo Lucas, MSW

  • Clinical Social Worker
  • Thousand Oaks, CA
National Provider Identifier
1679833230
Registry record updated May 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS 7544 Issued in CA
Practice address
627 Shenandoah St
Thousand Oaks, CA 91360-1532
Phone
(805) 241-5505
Fax
(805) 241-5404
NPI assigned
May 16, 2012
Last updated
May 16, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2012

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 7544 CA Primary

Addresses

Primary practice location

627 Shenandoah St
Thousand Oaks, CA 91360-1532

Mailing address

627 Shenandoah St
Thousand Oaks, CA 91360-1532
Phone (805) 241-5505

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
I20170407001388 CA Practitioner - Clinical Social Worker 0547546475 Reassigns benefits to 2 organizations
Practice locations: Newport Beach, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
K Allen Family Therapist IncGroup PAC ID 1951529775, 9 clinicians

Practice addresses (Care Compare)

4 Collingwood
Aliso Viejo, CA 92656-1939
Phone (949) 630-0584

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS 7544CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Moon Senior Counseling of California LLC Clinical CurrentSince Apr 24, 2018 Accepting new patients
K Allen Family Therapist Inc CurrentSince Jun 28, 2018 Accepting new patients
Darrell Broaddus Psychological Services PC Past Accepting new patients

Locations

10204 Bode St
Ste B
Plainfield, IL 60585
Phone (630) 229-6462

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1337126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337126400000",
    "number": "1679833230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "627 SHENANDOAH ST",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913601532",
            "telephone_number": "805-241-5505",
            "fax_number": "805-241-5404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "627 SHENANDOAH ST",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913601532",
            "telephone_number": "805-241-5505",
            "fax_number": "805-241-5404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "SHARON",
        "middle_name": "JO",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-16",
        "last_updated": "2012-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 7544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

Verify at the official NPI Registry.