Courtney Tierra Keith, LCSW 111075

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

120004 Issued in CA

Practice address

5060 Shoreham PL Ste 330
San Diego, CA 92122-5976

Phone

(619) 866-0998

NPI assigned

Oct 6, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in NC, TX, SC3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Merit-based Incentive Payment System (MIPS)

Final score

98.23 of 100Reported as group

Quality

88.23

Improvement activities

40

Cost

76.47

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: courtney.keith.p1@direct.sokya.nextgenshare.com
• Direct secure messaging: courtneykeith@tdh.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Brightside Medical, P.C.

  • Psychiatry Physician
  • San Francisco, CA
  • NPI 1801355482

  TX

  Medicare reassignment NPD
• BMSC NC LLC

  • Clinical Social Worker
  • Plainfield, IL
  • NPI 1831611649

  NC

  Medicare reassignment NPD
• BMSC TX LLC

  • Clinical Social Worker
  • Plainfield, IL
  • NPI 1215485198

  TX

  Medicare reassignment NPD
• Monarch

  • Community/Behavioral Health Agency
  • Albemarle, NC
  • NPI 1801116405
  Medicare reassignment NPD
• Step Up Care of North Carolina PC

  • Clinical Psychologist
  • Raleigh, NC
  • NPI 1841929395
  Medicare reassignment NPD
• Well America Inc.

  • Clinical Psychologist
  • Raleigh, NC
  • NPI 1053074765
  Medicare reassignment NPD
• Monarch

  • Community/Behavioral Health Agency
  • Wilmington, NC
  • NPI 1073267126
  NPD
• Monarch

  • Community/Behavioral Health Agency
  • Winston Salem, NC
  • NPI 1811306400
  NPD
• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Clinical

  NPD

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

{
    "created_epoch": "1507248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739491200000",
    "number": "1770093452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 WAGNER ST UNIT 262",
            "city": "TROUTMAN",
            "state": "NC",
            "postal_code": "281669627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5060 SHOREHAM PL STE 330",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921225976",
            "telephone_number": "619-866-0998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEITH",
        "first_name": "COURTNEY",
        "middle_name": "TIERRA",
        "credential": "LCSW 111075",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-06",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "111075",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S.1500130",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "120004",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C013689",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keith D. Vrhel MD Inc.
• Keith M. Hourihan Chiropractic, Inc.
• Keith Mahler Physical Therapist & Associates
• Emma Keith-Brown
• Andrew Jacob Keith, DDS
• Denise Keith
• Katherine Weaver Keith, LMFT
• Michele Keith, RN
• Paul Richard Keith, M.D.
• Cassandra Kekoa

• Clinical Social Worker in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2025; 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.

Verify at the official NPI Registry.