Phillip Tardanico, Licensed Clinical Social Worker & Associates, PC
NPI 1063020717ActiveOrganization· Social Worker, Clinical· Victorville, CA
Social Worker, Clinical in Victorville, California, registered in NPPES in July 2020. The authorized official on file is Phillip Tardanico, MSW, LCSW, President/Ceo. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1063020717 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 20, 2020 |
| Last updated in NPPES | Nov 23, 2021 |
| Certified by provider | Nov 9, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | — | — |
| Counselor, Addiction (Substance Use Disorder) | 101YA0400X | — | — |
| Marriage & Family Therapist | 106H00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (CA) |
|---|
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