Individual provider Active NPI

Matthew Steven Mollenhauer, LCSW

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1861962235
Registry record updated Jun 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW103794 Issued in CA
Practice address
3415 S Sepulveda Blvd FL 11
Los Angeles, CA 90034-6060
Phone
(530) 672-1785
NPI assigned
Nov 28, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X ASW85762 CA
Clinical Social Worker 1041C0700X LCSW103794 CA Primary

Addresses

Primary practice location

3415 S Sepulveda Blvd FL 11
Los Angeles, CA 90034-6060

Mailing address

8844 Fargo LN
Granite Bay, CA 95746-9671
Phone (530) 391-7491

Other practice location 1

982 Mission St
San Francisco, CA 94103-2911
Phone (415) 597-8072

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
ASW85762CAMDCounselor
LCSW103794CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1543363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749686400000",
    "number": "1861962235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8844 FARGO LN",
            "city": "GRANITE BAY",
            "state": "CA",
            "postal_code": "957469671",
            "telephone_number": "530-391-7491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 S SEPULVEDA BLVD FL 11",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900346060",
            "telephone_number": "530-672-1785"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "982 Mission St",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941032911",
            "country_code": "US",
            "telephone_number": "415-597-8072",
            "fax_number": "415-597-8004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOLLENHAUER",
        "first_name": "MATTHEW",
        "middle_name": "STEVEN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-11-28",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CA",
            "license": "ASW85762",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW103794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2025; 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.