Individual provider Active NPI

Cynthia Ann Engel, LCSW

  • Clinical Social Worker
  • Santa Rosa, CA
National Provider Identifier
1699884841
Registry record updated Sep 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS12263 Issued in CA
Practice address
2500 Vallejo St Ste 200
Santa Rosa, CA 95405-6959
Phone
(707) 528-2117
Fax
(707) 559-5091
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2018

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 LCS12263 CA Primary

Addresses

Primary practice location

2500 Vallejo St Ste 200
Santa Rosa, CA 95405-6959

Mailing address

515 Bodega Ave
Petaluma, CA 94952-1796
Phone (707) 528-2117

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
I20070130000220 CA Practitioner - Clinical Social Worker 9234130527 Practice locations: Santa Rosa, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2500 Vallejo St
Suite 200
Santa Rosa, CA 95405-6959
Phone (707) 528-2117

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS12263CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536883200000",
    "number": "1699884841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 BODEGA AVE",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949521796",
            "telephone_number": "707-528-2117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 VALLEJO ST STE 200",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954056959",
            "telephone_number": "707-528-2117",
            "fax_number": "707-559-5091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGEL",
        "first_name": "CYNTHIA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2018-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS12263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.