Individual provider Active NPI

Macy Kathryn McClung, LCSW

  • Clinical Social Worker
  • Alpine, CA
National Provider Identifier
1821865122
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
129300 Issued in CA
Practice address
2271 Alpine Blvd Ste a
Alpine, CA 91901-1101
Phone
(707) 529-0645
NPI assigned
Dec 6, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 105432 CA
Clinical Social Worker 1041C0700X 129300 CA Primary

Addresses

Primary practice location

2271 Alpine Blvd Ste a
Alpine, CA 91901-1101

Mailing address

2271 Alpine Blvd Ste a
Alpine, CA 91901-1101
Phone (707) 529-0645

Other practice location 1

4700 Spring St Ste 203
LA Mesa, CA 91942-0273
Phone (619) 549-0329 ext. 753

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
I20250423002184 CA Practitioner - Clinical Social Worker 9537684402 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2271 Alpine Blvd
Suite a
Alpine, CA 91901-1101
Phone (619) 448-1216

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
105432CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Fusion Care Group, a Psychological Professional Corporation CurrentSince Apr 1, 2025 Accepting new patients

Locations

2271 Alpine Blvd
Ste A
Alpine, CA 91901
Phone (619) 289-7322

3511 Camino del Rio S
Ste 102
San Diego, CA 92108
Phone (619) 289-7322

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": "1701820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1821865122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2271 ALPINE BLVD STE A",
            "city": "ALPINE",
            "state": "CA",
            "postal_code": "919011101",
            "telephone_number": "707-529-0645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2271 ALPINE BLVD STE A",
            "city": "ALPINE",
            "state": "CA",
            "postal_code": "919011101",
            "telephone_number": "707-529-0645"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4700 Spring St Ste 203",
            "address_purpose": "LOCATION",
            "city": "LA Mesa",
            "state": "CA",
            "postal_code": "919420273",
            "country_code": "US",
            "telephone_number": "619-549-0329 x753",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCLUNG",
        "first_name": "MACY",
        "middle_name": "KATHRYN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-06",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "105432",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "129300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpine, CA

Sources for this page

Verify at the official NPI Registry.