Individual provider Active NPI

Carol Ann Fred, LCSW

  • Clinical Social Worker
  • Pasadena, CA
National Provider Identifier
1841371127
Registry record updated Jun 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS4421 Issued in CA
Practice address
95 N Marengo Ave
Suite 200
Pasadena, CA 91101-1764
Phone
(626) 794-1120
Fax
(626) 316-6650
NPI assigned
Oct 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2015

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 LCS4421 CA Primary

Addresses

Primary practice location

95 N Marengo Ave
Suite 200
Pasadena, CA 91101-1764

Mailing address

95 N Marengo Ave
Suite 200
Pasadena, CA 91101-1764
Phone (626) 794-1120

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
I20100922000126 CA Practitioner - Clinical Social Worker 5193841625 Practice locations: Pasadena, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1968
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

95 N Marengo Ave
Suite 200
Pasadena, CA 91101-1746
Phone (626) 794-1120

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS4421CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Eft Resource Center Past Accepting new patients

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433635200000",
    "number": "1841371127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 N MARENGO AVE",
            "address_2": "SUITE 200",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911011764",
            "telephone_number": "626-794-1120",
            "fax_number": "626-316-6650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 N MARENGO AVE",
            "address_2": "SUITE 200",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911011764",
            "telephone_number": "626-794-1120",
            "fax_number": "626-316-6650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRED",
        "first_name": "CAROL",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2015-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS4421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.