Individual provider Active NPI

Mariya Charnaya Croshal, LCSW

  • Clinical Social Worker
  • Concord, CA
National Provider Identifier
1962948984
Registry record updated Sep 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
89645 Issued in CA
Practice address
785 Oak Grove Rd
Ste E2 Pmb4043
Concord, CA 94518
Phone
(925) 233-6391
NPI assigned
Jan 13, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2024

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 89645 CA Primary

Addresses

Primary practice location

785 Oak Grove Rd
Ste E2 Pmb4043
Concord, CA 94518

Mailing address

785 Oak Grove Rd
Ste E2 Pmb4043
Concord, CA 94518
Phone (925) 233-6391

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Previously, effective Aug 12, 2024 through Aug 12, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
89645CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1484265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1962948984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "785 OAK GROVE RD",
            "address_2": "STE E2 PMB4043",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "94518",
            "telephone_number": "925-233-6391",
            "fax_number": "925-233-6391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "785 OAK GROVE RD",
            "address_2": "STE E2 PMB4043",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "94518",
            "telephone_number": "925-233-6391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROSHAL",
        "first_name": "MARIYA",
        "middle_name": "CHARNAYA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-13",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "89645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, CA

Sources for this page

Verify at the official NPI Registry.