Individual provider Active NPI

Amy Lee Consolati, LCSW

  • Clinical Social Worker
  • San Luis Obispo, CA
National Provider Identifier
1891104493
Registry record updated Aug 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
25251 Issued in CA
Practice address
1530 Santa Rosa St
Apartment 7
San Luis Obispo, CA 93401-3750
Phone
(805) 458-5879
NPI assigned
Aug 7, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2014

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 25251 CA Primary

Addresses

Primary practice location

1530 Santa Rosa St
Apartment 7
San Luis Obispo, CA 93401-3750

Mailing address

1530 Santa Rosa St
Apartment 7
San Luis Obispo, CA 93401-3750
Phone (805) 458-5879

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
25251CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1407369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407369600000",
    "number": "1891104493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 SANTA ROSA ST",
            "address_2": "APARTMENT 7",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934013750",
            "telephone_number": "805-458-5879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 SANTA ROSA ST",
            "address_2": "APARTMENT 7",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934013750",
            "telephone_number": "805-458-5879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONSOLATI",
        "first_name": "AMY",
        "middle_name": "LEE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-07",
        "last_updated": "2014-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "25251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2014; 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.