Individual provider Active NPI

Virginia Sallie Macneil, LCSW

  • Clinical Social Worker
  • Santa Cruz, CA
National Provider Identifier
1720593601
Registry record updated Dec 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW26880 Issued in CA
Practice address
2850 Commercial Xing
Santa Cruz, CA 95065-1702
Phone
(831) 462-7178
Fax
(831) 458-5570
NPI assigned
Dec 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2017

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 LCSW26880 CA Primary

Addresses

Primary practice location

2850 Commercial Xing
Santa Cruz, CA 95065-1702

Mailing address

108 Avalon St
Santa Cruz, CA 95060-2202
Phone (831) 239-7922

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
I20210301002614 CA Practitioner - Clinical Social Worker 5799191631 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW26880CAMDClinical Social Worker
26880CAMDGeneral Practice Dentistry

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1513123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513123200000",
    "number": "1720593601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 AVALON ST",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950602202",
            "telephone_number": "831-239-7922",
            "fax_number": "831-458-5570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 COMMERCIAL XING",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651702",
            "telephone_number": "831-462-7178",
            "fax_number": "831-458-5570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACNEIL",
        "first_name": "VIRGINIA",
        "middle_name": "SALLIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-13",
        "last_updated": "2017-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW26880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

Verify at the official NPI Registry.