Individual provider Active NPI

Elizabeth Anna Mour, LCSW

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1700289493
Registry record updated May 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
88520 Issued in CA
Practice address
227 1/2 S Bonnie Beach PL
Los Angeles, CA 90063-3618
Phone
(323) 697-1913
NPI assigned
Oct 8, 2014
Last updated
May 1, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X ASW67613 CA
Clinical Social Worker 1041C0700X 88520 CA Primary

Addresses

Primary practice location

227 1/2 S Bonnie Beach PL
Los Angeles, CA 90063-3618

Mailing address

515 Columbia Ave Ste 300
Los Angeles, CA 90017-1209
Phone (323) 697-1913

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
I20190604000483 CA Practitioner - Clinical Social Worker 7113250366 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ASW67613CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles LGBT Center CurrentSince Jun 19, 2020 Accepting new patients
Los Angeles LGBT Center Clinical CurrentSince Jun 19, 2020 Accepting new patients
Special Service for Groups, Inc. CurrentSince Apr 6, 2019 Accepting new patients
Special Service for Groups, Inc. Current Accepting new patients
Special Service for Groups, Inc. CurrentSince Apr 6, 2019 Accepting new patients

Locations

1625 Schrader Blvd
Los Angeles, CA 90028
Phone (323) 993-7400

1625 Schrader Blvd
Fl 3
Los Angeles, CA 90028
Phone (323) 993-7400

905 E 8th St
Los Angeles, CA 90021
Phone (213) 553-1800

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

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": "1412726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556668800000",
    "number": "1700289493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 COLUMBIA AVE STE 300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900171209",
            "telephone_number": "323-697-1913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 1/2 S BONNIE BEACH PL",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900633618",
            "telephone_number": "323-697-1913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUR",
        "first_name": "ELIZABETH",
        "middle_name": "ANNA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-08",
        "last_updated": "2019-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW67613",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "88520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.