Individual provider Active NPI

Genevieve Brink-Capriola, LCSW

  • Clinical Social Worker
  • Chico, CA
National Provider Identifier
1760604367
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS 15642 Issued in CA
Practice address
15 Ilahee LN Ste 150
Chico, CA 95973-7205
Phone
(530) 876-3174
Fax
(530) 876-2183
NPI assigned
May 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X
Clinical Social Worker 1041C0700X LCS 15642 CA Primary

Addresses

Primary practice location

15 Ilahee LN Ste 150
Chico, CA 95973-7205

Mailing address

128 Zinnia Way
Chico, CA 95926-5201
Phone (530) 680-6923

Other identifiers 1

IdentifierTypeStateIssuer
LCS 15642OtherCASTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 1, 2022 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS 15642CAMDClinical Social Worker
15642CAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1760604367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 ZINNIA WAY",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959265201",
            "telephone_number": "530-680-6923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 ILAHEE LN STE 150",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959737205",
            "telephone_number": "530-876-3174",
            "fax_number": "530-876-2183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRINK-CAPRIOLA",
        "first_name": "GENEVIEVE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 15642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "LCS 15642",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chico, CA

Sources for this page

Verify at the official NPI Registry.