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MARIELA LICON LCSW
NPI 1497201602
Social Worker - Clinical in San Bernardino, CA

Active since August 28, 2016PECOS EnrolledAccepts Medicare Assignment
1500 N WATERMAN AVE, SAN BERNARDINO, CA 92404(909) 703-4099 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 11, 2025, Jul 8, 2025, Jul 24, 2023 and 1 more (4 updates tracked since 2016).

About Mariela Licon Lcsw NPPES

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

MARIELA LICON LCSW (NPI 1497201602) is an individual clinical provider in San Bernardino, California, licensed in California (LCSW131192) and active in the NPI registry since August 2016. She is enrolled in Medicare PECOS, maintains a secondary practice location in Riverside, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1497201602
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameMARIELA LICONCredential: LCSW
Location Address1500 N WATERMAN AVESan Bernardino, CA 92404-5111
Mailing Address1500 N Waterman AveSan Bernardino, CA 92404-5111 · (909) 703-4099
Phone(909) 703-4099
Sole ProprietorNo
Medical School CMSOtherGraduated 2018
Enumeration DateAugust 28, 2016
Last NPPES UpdateSeptember 11, 20254 updates tracked since enumeration
NPPES CertifiedSeptember 11, 2025
✔ NPI 1497201602 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Licenses✔ Licensed in CA · LCSW131192✔ Licensed in CA · 131192
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.
1500 N WATERMAN AVE, San Bernardino, CA 92404
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Secondary Practice Location 1

Location 110000 County Farm RdRiverside, CA 92503-3508 · Phone (951) 358-4400

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

Mariela Licon 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 ID1951817329
PECOS Enrollment IDI20250722003571
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 92404 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 $59.60 – $179.42
Typical copayment $0.00 (range $14.90 – $44.85)
Most-billed visit code NA
Established Patient
$74.08 typical visit price
range $19.37 – $146.42
Typical copayment $18.52 (range $4.84 – $36.60)
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.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BIANCA RAYLENE PINEDO
Community Health Worker
1500 N WATERMAN AVE
SAN BERNARDINO, CA 92404
San Bernardino County (213) 815-8392
ALLAN G KAVALICH MD INC
Internal Medicine (Nephrology)
1500 N WATERMAN AVE
SAN BERNARDINO, CA 92404
San Bernardino County (909) 381-1595
SAN BERNARDINO VALLEY HOME DIALYSIS CENTER, INC.
Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)
1500 N WATERMAN AVE, SUITE B
SAN BERNARDINO, CA 92404
San Bernardino County (909) 381-1595
FAVIOLA G GARCIA LCSW
Social Worker (Clinical)
1500 N WATERMAN AVE
SAN BERNARDINO, CA 92404
San Bernardino County (909) 703-4099
MS. BETH MARIE SPERRY NP
Nurse Practitioner (Obstetrics & Gynecology)
1500 N WATERMAN AVE
SAN BERNARDINO, CA 92404
San Bernardino County (909) 703-4099
RAI CARE CENTERS OF SOUTHERN CALIFORNIA I, LLC
Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)
1500 N WATERMAN AVE
SAN BERNARDINO, CA 92404
San Bernardino County (909) 381-1591
DR. ALLAN G KAVALICH M.D.
Internal Medicine (Nephrology)
1500 N WATERMAN AVE
SAN BERNARDINO, CA 92404
San Bernardino County (909) 381-1595
ST. JOHNS COMMUNITY HEALTH
Clinic/Center (Federally Qualified Health Center (FQHC))
1500 N WATERMAN AVE
SAN BERNARDINO, CA 92404
San Bernardino County (323) 541-1600

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 Mariela Licon's NPI number?

The NPI number for Mariela Licon is 1497201602. It was assigned to this individual provider in the NPPES registry on August 28, 2016.

Where is Mariela Licon located?

Mariela Licon practices at 1500 N Waterman Ave, San Bernardino, CA 92404. The listed phone number is (909) 703-4099.

What is Mariela Licon's specialty?

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

Is Mariela Licon enrolled in Medicare?

Yes. Mariela Licon 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 Mariela Licon was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.