Mayra Licano, LCSW

Primary specialty

School Social WorkerTaxonomy code 1041S0200X

License

LCSW103880 Issued in CA

Practice address

4200 Ashe Rd
Bakersfield, CA 93313-2029

Phone

(661) 809-0837

NPI assigned

Jun 14, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1560470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1760042535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9821 POCOHONTAS LN",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933114604",
            "telephone_number": "661-428-3670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 ASHE RD",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933132029",
            "telephone_number": "661-809-0837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICANO",
        "first_name": "MAYRA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-14",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW103880",
            "primary": false
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "CA",
            "license": "LCSW103880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• School Social Worker in Bakersfield, CA
• Providers in Bakersfield, CA by specialty
• School Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.