Active NPI
Kelly Van Cleave, LCSW
- Clinical Social Worker
- Vista, CA
National Provider Identifier
1811557663
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 78726
- Practice address
- 722 W California Ave
Vista, CA 92083-3565 - Phone
- (760) 941-6545
- Fax
- (760) 941-1715
- NPI assigned
- Jun 14, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 78726 | CA | Primary |
Addresses
Primary practice location
722 W California Ave
Vista, CA 92083-3565
Mailing address
1906 Willow Ridge Dr
Vista, CA 92081-7364
Phone (805) 907-9317
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 |
|---|---|---|---|
| 78726 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Solutions for Change, Inc | Clinical | Past | Accepting new patients |
Interoperability endpoints
- kelly.van.cleave.1@29558.direct.athenahealth.com
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.
-
- Clinical Social Worker
- Vista, CA
- NPI 1942770110
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560470400000",
"number": "1811557663",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1906 WILLOW RIDGE DR",
"city": "VISTA",
"state": "CA",
"postal_code": "920817364",
"telephone_number": "805-907-9317"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "722 W CALIFORNIA AVE",
"city": "VISTA",
"state": "CA",
"postal_code": "920833565",
"telephone_number": "760-941-6545",
"fax_number": "760-941-1715"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN CLEAVE",
"first_name": "KELLY",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-14",
"last_updated": "2019-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "78726",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vista, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.