Charles Douglas Stafford, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

96730 Issued in CA

Practice address

3330 Harbor Blvd
Costa Mesa, CA 92626-1502

Phone

(714) 861-9044

NPI assigned

Sep 8, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Flowmind Counseling Licensed Clinical Social Worker, Inc.

  • Clinical Social Worker
  • Costa Mesa, CA
  • NPI 1831060359
  NPD Authorized official

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

{
    "created_epoch": "1599523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743206400000",
    "number": "1962016832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10085 CORRAL RIVER CT",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927086812",
            "telephone_number": "714-861-9044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 HARBOR BLVD",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926261502",
            "telephone_number": "714-861-9044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAFFORD",
        "first_name": "CHARLES",
        "middle_name": "DOUGLAS",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-08",
        "last_updated": "2025-03-29",
        "certification_date": "2025-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "96730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St. Joseph Health System Home Care Services
• St. Joseph Health System Home Care Services
• Stacey Gillis Chiropractic Inc
• Danielle Stadelman, RDN
• Lindsay Wofford Stadler
• Diana Stafford, COUNSELOR
• Kelleen Carrie Stainer
• Lauren Stairs
• Roxanne Stallworth, M.D., M.P.H.
• Stanley Robert Stanbridge, D.C.

• Clinical Social Worker in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 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.