MINDFUL HEALING LICENSED CLINICAL SOCIAL WORKER PC
NPI 1245067321
Social Worker - Clinical in Emeryville, CA

Q: What is Mindful Healing Licensed Clinical Social Worker PC's specialty?

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

Active since September 13, 2024

1394 PARK AVE, EMERYVILLE, CA 94608(510) 384-3373 Get Directions Write a Review

NPPES record last updated: July 29, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Mindful Healing Licensed Clinical Social Worker Pc NPPES

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

MINDFUL HEALING LICENSED CLINICAL SOCIAL WORKER PC (NPI 1245067321) is a healthcare organization registered as a clinical in Emeryville, California and active in the NPI registry since September 2024. The organization lists Rebecca M Olsen, Owner, as its authorized official.

NPPES Registry Identity

NPI1245067321

Entity TypeOrganization

Primary Taxonomy1041C0700X

Legal Business NameMINDFUL HEALING LICENSED CLINICAL SOCIAL WORKER PC

Location Address1394 PARK AVEEmeryville, CA 94608-3537

Mailing Address1394 Park AveEmeryville, CA 94608-3537 · (510) 384-3373

Phone(510) 384-3373

Organization SubpartNo

Authorized OfficialRebecca M OlsenOwner · (510) 384-3373

Enumeration DateSeptember 13, 2024

Last NPPES UpdateJuly 29, 2025

NPPES CertifiedJuly 29, 2025

✔ NPI 1245067321 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

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.

1394 PARK AVE, Emeryville, CA 94608

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mindful Healing Licensed Clinical Social Worker Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Mindful Healing Licensed Clinical Social Worker PC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Rebecca Olsen, LCSW

Clinical Social Worker

NPI 1740565621

1394 PARK AVE
Emeryville, CA 94608

(510) 384-3373

✔ PECOSSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Mindful Healing Licensed Clinical Social Worker PC's NPI number?

The NPI number for Mindful Healing Licensed Clinical Social Worker PC is 1245067321. It was assigned to this organization in the NPPES registry on September 13, 2024.

Where is Mindful Healing Licensed Clinical Social Worker PC located?

Mindful Healing Licensed Clinical Social Worker PC is located at 1394 Park Ave, Emeryville, CA 94608. The listed phone number is (510) 384-3373.

What is Mindful Healing Licensed Clinical Social Worker PC's specialty?

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

Is Mindful Healing Licensed Clinical Social Worker PC enrolled in Medicare?

Yes. Mindful Healing Licensed Clinical Social Worker PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Mindful Healing Licensed Clinical Social Worker PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Social Worker) reassigns their Medicare billing to Mindful Healing Licensed Clinical Social Worker PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Mindful Healing Licensed Clinical Social Worker PC was last updated on July 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.