Individual provider Active NPI

Michelle Flicht-McDonough, LCSW

  • Clinical Social Worker
  • Sacramento, CA
National Provider Identifier
1922017771
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS19201 Issued in CA
Practice address
3101 I St
Suite #204
Sacramento, CA 95816-4421
Phone
(916) 446-3045
Fax
(916) 486-7062
NPI assigned
Aug 7, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 LCS19201 CA Primary

Addresses

Primary practice location

3101 I St
Suite #204
Sacramento, CA 95816-4421

Mailing address

3101 I St.
Suite #204
Sacramento, CA 95816-4421
Phone (916) 446-3045

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
LCS19201CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922017771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 I ST.",
            "address_2": "SUITE #204",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958164421",
            "telephone_number": "916-446-3045",
            "fax_number": "916-486-7062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 I ST",
            "address_2": "SUITE #204",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958164421",
            "telephone_number": "916-446-3045",
            "fax_number": "916-486-7062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLICHT-MCDONOUGH",
        "first_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS19201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.