Active NPI
Rebecca Allison Courry, LCSW
- Clinical Social Worker
- Oakland, CA
National Provider Identifier
1891004537
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 66065
- Practice address
- 600 Grand Ave Ste 301
Oakland, CA 94610-3548 - Phone
- (510) 846-9340
- NPI assigned
- Sep 29, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Social Worker | 104100000X | |||
| Case Manager/Care Coordinator | 171M00000X | |||
| Clinical Social Worker | 1041C0700X | 66065 | CA | Primary |
Addresses
Primary practice location
600 Grand Ave Ste 301
Oakland, CA 94610-3548
Mailing address
600 Grand Ave Ste 301
Oakland, CA 94610-3548
Phone (510) 846-9340
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720385032 | Medicaid | CA | |
| 1942507835 | Medicaid | CA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 66065 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1506988800000",
"number": "1891004537",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 GRAND AVE STE 301",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946103548",
"telephone_number": "510-846-9340"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 GRAND AVE STE 301",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946103548",
"telephone_number": "510-846-9340"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COURRY",
"first_name": "REBECCA",
"middle_name": "ALLISON",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-09-29",
"last_updated": "2017-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "66065",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1720385032",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1942507835",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.