Genevieve Marilyn Banegas, LCSW, PPSC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

77553 Issued in CA

Practice address

205 South St
Fort Bragg, CA 95437

Phone

(707) 961-3492

NPI assigned

Oct 8, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Genevieve Marilyn Gonzalez Former name

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

Specialty

Clinical Social Worker

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mendocino Coast Clinics, IncGroup PAC ID 5991619157, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: genevieve.gonzales.p1@direct.mccinc.nextgenshare.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Mendocino Coast Clinics Inc

  • Federally Qualified Health Center (FQHC)
  • Fort Bragg, CA
  • NPI 1609595404
  Medicare reassignment Care Compare group NPD
• Mendocino Coast Clinics Inc

  • Federally Qualified Health Center (FQHC)
  • Fort Bragg, CA
  • NPI 1083783757
  NPD
• Mendocino Coast Clinics, Inc.

  • Federally Qualified Health Center (FQHC)
  • Fort Bragg, CA
  • NPI 1285128595
  NPD

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

{
    "created_epoch": "1349654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788480000000",
    "number": "1821340480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 SOUTH ST",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "954375540",
            "telephone_number": "707-964-1251",
            "fax_number": "707-961-2722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 SOUTH ST",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "95437",
            "telephone_number": "707-961-3492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANEGAS",
        "first_name": "GENEVIEVE",
        "middle_name": "MARILYN",
        "credential": "LCSW, PPSC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-08",
        "last_updated": "2026-09-04",
        "certification_date": "2026-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "77553",
            "primary": true
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GENEVIEVE",
            "last_name": "GONZALEZ",
            "middle_name": "MARILYN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Apria Healthcare LLC
• Marcia Ann Astier, RDH
• Waseem Rasem Bader
• Gregory Baer
• M. Lee Baker, DDS
• Nadine R. Barlow, PHARMD
• Willow Bartholomew, PA
• Kenneth Roger Baumgartner, DDS
• Carrie Becker Fishman
• Joseph Edward Beeney, PHD

• Clinical Social Worker in Fort Bragg, CA
• Providers in Fort Bragg, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.