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DIVINITY STAR LCSW
NPI 1124501697
Social Worker - Clinical in Santa Clarita, CA

Active since September 11, 2018PECOS EnrolledAccepts Medicare Assignment
22830 BANYAN PL UNIT 16, SANTA CLARITA, CA 91390(424) 200-1553 Get Directions Write a Review

NPPES record last updated: July 16, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 4, 2021, Sep 14, 2018 (2 updates tracked since 2018).

About Divinity Star Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DIVINITY STAR LCSW (NPI 1124501697) is an individual clinical provider in Santa Clarita, California, licensed in California (104320) and active in the NPI registry since September 2018. She is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1124501697
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameDIVINITY STARCredential: LCSW
Location Address22830 BANYAN PL UNIT 16Santa Clarita, CA 91390-4282
Mailing Address22830 Banyan Pl Unit 16Santa Clarita, CA 91390-4282 · (424) 200-1553
Phone(424) 200-1553
Sole ProprietorYes
Medical School CMSOtherGraduated 2017
Enumeration DateSeptember 11, 2018
Last NPPES UpdateJuly 16, 20252 updates tracked since enumeration
NPPES CertifiedJuly 16, 2025
✔ NPI 1124501697 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in CA · 104320
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
22830 BANYAN PL UNIT 16, Santa Clarita, CA 91390
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Divinity Star Lcsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3971996737
PECOS Enrollment IDI20220131002564
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 91390 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $62.96 – $187.60
Typical copayment $0.00 (range $15.74 – $46.90)
Most-billed visit code NA
Established Patient
$77.96 typical visit price
range $20.84 – $153.61
Typical copayment $19.49 (range $5.21 – $38.40)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Divinity Star's NPI number?

The NPI number for Divinity Star is 1124501697. It was assigned to this individual provider in the NPPES registry on September 11, 2018.

Where is Divinity Star located?

Divinity Star practices at 22830 Banyan Pl Unit 16, Santa Clarita, CA 91390. The listed phone number is (424) 200-1553.

What is Divinity Star's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Divinity Star enrolled in Medicare?

Yes. Divinity Star is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Divinity Star was last updated on July 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.