Active NPI
Cecilia Habacon, LCSW
- Clinical Social Worker
- Long Beach, CA
National Provider Identifier
1710385125
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 29063
- Practice address
- 2850 Daisy Ave
Long Beach, CA 90806-1430 - Phone
- (562) 818-7906
- NPI assigned
- Dec 17, 2014
- Last updated
- Dec 17, 2014
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 29063 | CA | Primary |
Addresses
Primary practice location
2850 Daisy Ave
Long Beach, CA 90806-1430
Mailing address
2850 Daisy Ave
Long Beach, CA 90806-1430
Phone (562) 818-7906
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 29063 | Other | CA | BOARD OF BEHAVIORAL SCIENCES |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 29063 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1418774400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1418774400000",
"number": "1710385125",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2850 DAISY AVE",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908061430",
"telephone_number": "562-818-7906"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2850 DAISY AVE",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908061430",
"telephone_number": "562-818-7906"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HABACON",
"first_name": "CECILIA",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-12-17",
"last_updated": "2014-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "29063",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF BEHAVIORAL SCIENCES",
"identifier": "29063",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.