Active NPI
Kathryn A Aceto, LCSW
- Clinical Social Worker
- Arroyo Grande, CA
National Provider Identifier
1972664159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS27214
- Practice address
- 501 Ide St Apt B
Arroyo Grande, CA 93420-3445 - Phone
- (207) 807-4095
- Fax
- (805) 202-8510
- NPI assigned
- Dec 12, 2006
- Last updated
- Jul 24, 2011
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | LC 10015 | ME | |
| Clinical Social Worker | 1041C0700X | ASW 23427 | CA | |
| Clinical Social Worker | 1041C0700X | LCS27214 | CA | Primary |
Addresses
Primary practice location
501 Ide St Apt B
Arroyo Grande, CA 93420-3445
Mailing address
501 Ide St Apt B
Arroyo Grande, CA 93420-3445
Phone (207) 807-4095
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 432043900 | Medicaid | ME | |
| 100554 | Other | ME | ANTHEM |
| 100554 | Other | ME | MMC PHO |
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 |
|---|---|---|---|
| LC 10015 | ME | MD | Social Worker |
| ASW 23427 | CA | MD | Clinical Social Worker |
| LCS27214 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311465600000",
"number": "1972664159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 IDE ST APT B",
"city": "ARROYO GRANDE",
"state": "CA",
"postal_code": "934203445",
"telephone_number": "207-807-4095",
"fax_number": "805-202-8510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 IDE ST APT B",
"city": "ARROYO GRANDE",
"state": "CA",
"postal_code": "934203445",
"telephone_number": "207-807-4095",
"fax_number": "805-202-8510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ACETO",
"first_name": "KATHRYN",
"middle_name": "A",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-12",
"last_updated": "2011-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "ME",
"license": "LC 10015",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "ASW 23427",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS27214",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "432043900",
"state": "ME"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "100554",
"state": "ME"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MMC PHO",
"identifier": "100554",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}Other providers in Arroyo Grande, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.