Phyllis M Addis, LCSW

Individual provider Active NPI Clinical Social Worker · Chico, CA

NPI 1811913882 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1811913882
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
LCSW1164C (AL)
Practice address
845 W East Ave
Chico, CA 95926-2002
Phone
(530) 896-4851
Fax
(530) 896-9407
NPI assigned
Jul 14, 2006
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LCSW1164CALMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW1164C AL Yes

Addresses

Primary practice location

845 W East Ave
Chico, CA 95926-2002

Mailing address

845 W East Ave
Chico, CA 95926-2002
Phone (530) 896-4851

Other providers in Chico, CA

All providers in Chico, CA · Clinical Social Worker in California

Sources for this page

Verify at the official NPI Registry.