Individual provider Active NPI

La Shawn Monic Miggins, LCSW

  • Clinical Social Worker
  • Martinez, CA
National Provider Identifier
1790230902
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
25 Allen Street
Martinez, CA 94553
Phone
(707) 315-8429
NPI assigned
Aug 17, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW86031 CA
Student in an Organized Health Care Education/Training Program 390200000X ASW 61703 CA
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

25 Allen Street
Martinez, CA 94553

Mailing address

1025 Roosevelt St
Fairfield, CA 94533-4431
Phone (707) 315-8429

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LCSW86031CAMDClinical Social Worker
ASW 61703CAMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1471392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1790230902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 ROOSEVELT ST",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945334431",
            "telephone_number": "707-315-8429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 ALLEN STREET",
            "city": "MARTINEZ",
            "state": "CA",
            "postal_code": "94553",
            "telephone_number": "707-315-8429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIGGINS",
        "first_name": "LA SHAWN",
        "middle_name": "MONIC",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-17",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW86031",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "ASW 61703",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinez, CA

Sources for this page

Verify at the official NPI Registry.