Active NPI
Kenneth Charles Chadwick Jr.
- Clinical Social Worker
- Indio, CA
National Provider Identifier
1790201432
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 130717
- Practice address
- 44199 Monroe St
Indio, CA 92201-3096 - Phone
- (760) 863-7148
- NPI assigned
- Aug 15, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | R1466610422 | CA | |
| Case Manager/Care Coordinator | 171M00000X | R1466610422 | CA | |
| Clinical Social Worker | 1041C0700X | 130717 | CA | Primary |
| Peer Specialist | 175T00000X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | CA |
Addresses
Primary practice location
44199 Monroe St
Indio, CA 92201-3096
Mailing address
9825 Magnolia Ave Ste B
Riverside, CA 92503-3565
Phone (951) 509-2499
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 |
|---|---|---|---|
| 130717 | CA | MD | Marriage & Family Therapist |
| R1466610422 | CA | MD | Case Manager/Care Coordinator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754524800000",
"number": "1790201432",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9825 MAGNOLIA AVE STE B",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925033565",
"telephone_number": "951-509-2499"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44199 MONROE ST",
"city": "INDIO",
"state": "CA",
"postal_code": "922013096",
"telephone_number": "760-863-7148"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHADWICK",
"first_name": "KENNETH",
"middle_name": "CHARLES",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-08-15",
"last_updated": "2025-08-07",
"certification_date": "2025-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "R1466610422",
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "CA",
"license": "R1466610422",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "130717",
"primary": true
},
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": null,
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CA",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indio, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.