Individual provider Active NPI

Judith H Sills, LCSW

  • Clinical Social Worker
  • Newport Beach, CA
National Provider Identifier
1861615502
Registry record updated Mar 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS7974 Issued in CA
Practice address
23 Fremont Street
Newport Beach, CA 92663-4427
Phone
(714) 329-2248
Fax
(949) 723-1937
NPI assigned
Apr 11, 2007
Last updated
Mar 18, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2008

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 LCS7974 CA Primary

Addresses

Primary practice location

23 Fremont Street
Newport Beach, CA 92663-4427

Mailing address

16052 Beach Blvd
Suite 228
Huntington Beach, CA 92647-3801
Phone (714) 841-3465

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS7974CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lucretia a. Reed Past Accepting new patients
Constance Bouvier, PH.D., Clinical Psychologist, Inc. Past Accepting new patients

Organizations & group practices 2

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": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205798400000",
    "number": "1861615502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16052 BEACH BLVD",
            "address_2": "SUITE 228",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926473801",
            "telephone_number": "714-841-3465",
            "fax_number": "949-723-1937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 FREMONT STREET",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926634427",
            "telephone_number": "714-329-2248",
            "fax_number": "949-723-1937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SILLS",
        "first_name": "JUDITH",
        "middle_name": "H",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-11",
        "last_updated": "2008-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS7974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.