Active NPI
Julie Annette Doerner, LCSW
- Clinical Social Worker
- Arcata, CA
National Provider Identifier
1720674286
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS15160
- Practice address
- 822 G St Ste C
Arcata, CA 95521-6223 - Phone
- (616) 226-6138
- NPI assigned
- Dec 17, 2020
- 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 | LCS15160 | CA | Primary |
Addresses
Primary practice location
822 G St Ste C
Arcata, CA 95521-6223
Mailing address
PO Box 609
Ada, MI 49301-0609
Phone (616) 226-6138
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210112003265 | CA | Practitioner - Clinical Social Worker | 9638582638 | Practice locations: McKinleyville, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
3200 Arthur Rd
McKinleyville, CA 95519-7703
Phone (707) 834-4756
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCS15160 | CA | MD | Clinical Social Worker |
| 15160 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1608163200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608163200000",
"number": "1720674286",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 609",
"city": "ADA",
"state": "MI",
"postal_code": "493010609",
"telephone_number": "616-226-6138"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "822 G ST STE C",
"city": "ARCATA",
"state": "CA",
"postal_code": "955216223",
"telephone_number": "616-226-6138"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOERNER",
"first_name": "JULIE",
"middle_name": "ANNETTE",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-12-17",
"last_updated": "2020-12-17",
"certification_date": "2020-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS15160",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Arcata, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.