Clint Edwards

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

106487 Issued in CA

Practice address

58811 Santa Barbara Dr
Yucca Valley, CA 92284-6459

Phone

(760) 702-6188

Fax

(760) 560-5924

NPI assigned

Sep 21, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

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 2

Specialty

Clinical Social Worker

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846
  Medicare reassignment NPD
• Sud Specialty Group - Ca

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Santa Clara, CA
  • NPI 1972138238

  Clinical

  Medicare reassignment NPD
• Lutheran Social Services of Southern California

  • Case Manager/Care Coordinator
  • Yucca Valley, CA
  • NPI 1437555117
  NPD (past)

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

{
    "created_epoch": "1442793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683590400000",
    "number": "1821467705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58811 SANTA BARBARA DR",
            "city": "YUCCA VALLEY",
            "state": "CA",
            "postal_code": "922846459",
            "telephone_number": "760-702-6188",
            "fax_number": "760-560-5924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58811 SANTA BARBARA DR",
            "city": "YUCCA VALLEY",
            "state": "CA",
            "postal_code": "922846459",
            "telephone_number": "760-702-6188",
            "fax_number": "760-560-5924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "CLINT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-09-21",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "95-2225798",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "106487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Starlyn Kanada Eckerman
• Angelique Eddins
• Sherri Lynn Edelstein
• Amy Eden
• Edith a. Jones-Poland MD Professional Corp
• Jacqueline Edwards
• Effel LLC Dba Effel Medical Respite
• Eisenhower Medical Center
• Eliott Romero, MD Corp
• Ellee Residential Care #3

• Clinical Social Worker in Yucca Valley, CA
• Providers in Yucca Valley, 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 May 9, 2023; 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.