Individual provider Active NPI

Michelle Reyes-Neil, LCSW

  • Clinical Social Worker
  • Castro Valley, CA
National Provider Identifier
1750855516
Registry record updated Jan 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW87424 Issued in CA
Practice address
3033 Grove Way Apt C
Castro Valley, CA 94546-6702
Phone
(831) 915-3994
NPI assigned
Jan 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2019

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 LCSW87424 CA Primary

Addresses

Primary practice location

3033 Grove Way Apt C
Castro Valley, CA 94546-6702

Mailing address

3033 Grove Way Apt C
Castro Valley, CA 94546-6702
Phone (831) 915-3994

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: No
  • 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
I20230530000949 CA Practitioner - Clinical Social Worker 6709243272 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW87424CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mood Clinical, P. C. CurrentSince Jan 21, 2023 Accepting new patients
Glenn Medical Center, LLC PastSince Jan 21, 2023 Accepting new patients

Locations

18191 Von Karman Ave
Ste 100
Irvine, CA 92612
Phone (530) 889-7293

Organizations & group practices 2

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": "1547510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547510400000",
    "number": "1750855516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3033 GROVE WAY APT C",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945466702",
            "telephone_number": "831-915-3994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 GROVE WAY APT C",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945466702",
            "telephone_number": "831-915-3994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES-NEIL",
        "first_name": "MICHELLE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-15",
        "last_updated": "2019-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW87424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Castro Valley, CA

Sources for this page

Verify at the official NPI Registry.