Individual provider Active NPI

Thomas Joseph Dunleavy, LCSW

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1689198764
Registry record updated Apr 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW103340 Issued in CA
Practice address
5665 Wilshire Blvd Ste 1206
Los Angeles, CA 90036-3710
Phone
(213) 583-2170
NPI assigned
Jul 31, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 83293 CA
Mental Health Counselor 101YM0800X LCSW103340 CA
Clinical Social Worker 1041C0700X 103340 CA
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Social Worker 1041C0700X LCSW103340 CA Primary

Addresses

Primary practice location

5665 Wilshire Blvd Ste 1206
Los Angeles, CA 90036-3710

Mailing address

5665 Wilshire Blvd Ste 1206
Los Angeles, CA 90036-3710
Phone (213) 583-2170

Other practice location 1

4760 Sepulveda Blvd
Culver City, CA 90230-4820
Phone (310) 751-5284

Other practice location 2

3303 N Broadway
Los Angeles, CA 90031-2803
Phone (323) 478-8200

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
LCSW103340CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1501459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1689198764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5665 WILSHIRE BLVD STE 1206",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900363710",
            "telephone_number": "213-583-2170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5665 WILSHIRE BLVD STE 1206",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900363710",
            "telephone_number": "213-583-2170"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4760 Sepulveda Blvd",
            "address_purpose": "LOCATION",
            "city": "Culver City",
            "state": "CA",
            "postal_code": "902304820",
            "country_code": "US",
            "telephone_number": "310-751-5284",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3303 N Broadway",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900312803",
            "country_code": "US",
            "telephone_number": "323-478-8200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUNLEAVY",
        "first_name": "THOMAS",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-31",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "83293",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "LCSW103340",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "103340",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW103340",
            "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 Apr 19, 2023; 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.