Active NPI
Geoffrey Mellon, LCSW
- Social Worker
- Los Angeles, CA
National Provider Identifier
1699101956
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- LCSW88540
- Practice address
- 3200 Motor Ave
Los Angeles, CA 90034-3710 - Phone
- (310) 836-1223
- Fax
- (310) 204-4134
- NPI assigned
- Sep 18, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | LCSW88540 | CA | Primary |
Addresses
Primary practice location
3200 Motor Ave
Los Angeles, CA 90034-3710
Mailing address
3200 Motor Ave
Los Angeles, CA 90034-3710
Phone (310) 836-1223
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW88540 | CA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1379462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556064000000",
"number": "1699101956",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3200 MOTOR AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900343710",
"telephone_number": "310-836-1223",
"fax_number": "310-204-4134"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3200 MOTOR AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900343710",
"telephone_number": "310-836-1223",
"fax_number": "310-204-4134"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MELLON",
"first_name": "GEOFFREY",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-09-18",
"last_updated": "2019-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "LCSW88540",
"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 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.