Individual provider Active NPI

Chelsea Canning, LCSW

  • Mental Health Counselor
  • El Segundo, CA
National Provider Identifier
1770095812
Registry record updated Oct 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
76411 Issued in CA
Practice address
214 Main St Ste 272
El Segundo, CA 90245-3803
Phone
(310) 616-3041
Fax
(310) 616-3041
NPI assigned
Oct 30, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 76411 CA Primary

Addresses

Primary practice location

214 Main St Ste 272
El Segundo, CA 90245-3803

Mailing address

214 Main St Ste 272
El Segundo, CA 90245-3803

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20180316001464 CA Practitioner - Clinical Social Worker 4183986805 Practice locations: Los Angeles, CA; Manhattan Beach, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1230 Rosecrans Ave
Suite 300
Manhattan Beach, CA 90266-2494
Phone (310) 341-9512

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
76411CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Total Care Management Services, Inc Mental Health Current Accepting new patients

Locations

214 Main St
El Segundo, CA 90245
Phone (310) 295-8666

10801 National Blvd
Ste 253
Los Angeles, CA 90064
Phone (310) 310-9356

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1509321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509321600000",
    "number": "1770095812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 MAIN ST STE 272",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902453803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 MAIN ST STE 272",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902453803",
            "telephone_number": "310-616-3041",
            "fax_number": "310-616-3041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNING",
        "first_name": "CHELSEA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-30",
        "last_updated": "2017-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "76411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Segundo, CA

Sources for this page

Verify at the official NPI Registry.