Active NPI
Garett Staley, LCSW
- Clinical Social Worker
- Pomona, CA
National Provider Identifier
1790067296
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS27321
- Practice address
- 845 E Arrow Hwy
Pomona, CA 91767-2535 - Phone
- (909) 624-1233
- Fax
- (909) 621-5999
- NPI assigned
- Sep 12, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CCS 09040 | CA | |
| Clinical Social Worker | 1041C0700X | LCS27321 | CA | Primary |
Addresses
Primary practice location
845 E Arrow Hwy
Pomona, CA 91767-2535
Mailing address
845 E Arrow Hwy
Pomona, CA 91767-2535
Phone (909) 624-1233
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CCS 09040 | CA | MD | Addiction (Substance Use Disorder) Counselor |
| LCS27321 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452211200000",
"number": "1790067296",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "845 E ARROW HWY",
"city": "POMONA",
"state": "CA",
"postal_code": "917672535",
"telephone_number": "909-624-1233",
"fax_number": "909-621-5999"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "845 E ARROW HWY",
"city": "POMONA",
"state": "CA",
"postal_code": "917672535",
"telephone_number": "909-624-1233",
"fax_number": "909-621-5999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STALEY",
"first_name": "GARETT",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-12",
"last_updated": "2016-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "CCS 09040",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS27321",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pomona, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.