Individual provider Active NPI

Brian Conlan, MSW LCSW

  • Counselor
  • Glendale, CA
National Provider Identifier
1801906920
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
LCS4412 Issued in CA
Practice address
6425 San Fernando Rd
Glendale, CA 91201
Phone
(818) 956-0101
Fax
(818) 956-1413
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X LCS4412 CA Primary

Addresses

Primary practice location

6425 San Fernando Rd
Glendale, CA 91201

Mailing address

6425 San Fernando Rd
Glendale, CA 91201
Phone (818) 956-0101

Other identifiers 1

IdentifierTypeStateIssuer
LCS4412OtherCACALIFORNIA

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
I20110215000430 CA Practitioner - Clinical Social Worker 6103006705 Practice locations: Glendale, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6425 San Fernando Rd
Glendale, CA 91201-3624
Phone (818) 956-0101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS4412CAMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Eating Disorder Institute of California Past Accepting new patients

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801906920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6425 SAN FERNANDO RD",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "91201",
            "telephone_number": "818-956-0101",
            "fax_number": "818-956-1413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6425 SAN FERNANDO RD",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "91201",
            "telephone_number": "818-956-0101",
            "fax_number": "818-956-1413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONLAN",
        "first_name": "BRIAN",
        "name_prefix": "Mr.",
        "credential": "MSW LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CA",
            "license": "LCS4412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA",
            "identifier": "LCS4412",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.