Organization Active NPI

Opus Counseling Services a Licensed Clinical Social Worker Corporation

  • Clinical Social Worker
  • Signal Hill, CA
National Provider Identifier
1760023964
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
OPUS COUNSELING SERVICES A LICENSED CLINICAL SOCIAL WORKER CORPORATION
Practice address
2698 Dawson Ave Ste G
Signal Hill, CA 90755-2066
Phone
(562) 619-9700
NPI assigned
Sep 30, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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

Authorized official

Name
Kathleen Villagomez, LCSWNPI 1144309352
Title
Administrator
Phone
(562) 619-9700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

2698 Dawson Ave Ste G
Signal Hill, CA 90755-2066

Mailing address

3553 Atlantic Ave # 670
Long Beach, CA 90807-5606

Other names 1

  • Opus Counseling Services Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@kathleencounseling.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230608002564 CA Part B Supplier - Clinic/Group Practice 7214394030 Receives reassigned benefits from 1 practitioner
Practice locations: Signal Hill, CA

National Provider Directory

National Provider Directory

Locations

3553 Atlantic Ave
#670
Long Beach, CA 90807

3553 Atlantic Ave
Ste 670
Long Beach, CA 90807

2698 Dawson Ave
Ste G
Signal Hill, CA 90755
Phone (562) 452-4810

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1569801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686528000000",
    "number": "1760023964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3553 ATLANTIC AVE # 670",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908075606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2698 DAWSON AVE STE G",
            "city": "SIGNAL HILL",
            "state": "CA",
            "postal_code": "907552066",
            "telephone_number": "562-619-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPUS COUNSELING SERVICES A LICENSED CLINICAL SOCIAL WORKER CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-30",
        "last_updated": "2023-06-12",
        "certification_date": "2023-05-05",
        "status": "A",
        "authorized_official_last_name": "VILLAGOMEZ",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "562-619-9700",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@kathleencounseling.com",
            "affiliation": "N",
            "endpointDescription": "encrypted for security email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "encrypted messaging",
            "address_1": "2301 E 28th St Ste 309",
            "city": "Signal Hill",
            "state": "CA",
            "country_code": "US",
            "postal_code": "907552181",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Opus Counseling Services",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Opus Counseling Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Signal Hill, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.