Individual provider Active NPI

Eugenie Boiadjieva, L.C.S.W.

  • Clinical Social Worker
  • Long Beach, CA
National Provider Identifier
1841310240
Registry record updated Feb 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS 21744 Issued in CA
Practice address
100 W Broadway Ste 5010
Long Beach, CA 90802-9409
Phone
(562) 260-5197
NPI assigned
Mar 30, 2007
Last updated
Feb 6, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCS 21744 CA Primary

Addresses

Primary practice location

100 W Broadway Ste 5010
Long Beach, CA 90802-9409

Mailing address

3702 Almeria St
San Pedro, CA 90731-6412
Phone (562) 285-0149

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
I20100512000839 CA Practitioner - Clinical Social Worker 8325176324 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1995
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Recovery Now Licensed Clinical Social Work, Inc.Group PAC ID 5597827584, 2 clinicians

Practice addresses (Care Compare)

2138 Fairhill Dr
Rancho Palos Verdes, CA 90275-1310
Phone (310) 957-2099

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS 21744CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health America of Los Angeles CurrentSince Feb 28, 2024 Accepting new patients
Mental Health America of Los Angeles Current Accepting new patients
Recovery Now Licensed Clinical Social Work, Inc. Clinical CurrentSince Jul 1, 2015 Accepting new patients

Locations

100 W Broadway
Ste 5010
Long Beach, CA 90802

1955 Long Beach Blvd
Long Beach, CA 90806
Phone (562) 533-4942

916 N Western Ave
Ste 210
San Pedro, CA 90732
Phone (310) 776-7406

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328486400000",
    "number": "1841310240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3702 ALMERIA ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907316412",
            "telephone_number": "562-285-0149",
            "fax_number": "562-285-0156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W BROADWAY STE 5010",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908029409",
            "telephone_number": "562-260-5197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOIADJIEVA",
        "first_name": "EUGENIE",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-30",
        "last_updated": "2012-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 21744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.