Jeremy Lightell, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW93817 Issued in CA

Practice address

409 Jackson St
Hayward, CA 94544-1530

Phone

(510) 891-5600

NPI assigned

Jan 14, 2009

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Alameda County

  dba South County Crisis

  • Community/Behavioral Health Agency
  • Hayward, CA
  • NPI 1780716381
  Medicare reassignment
• Alameda County

  dba Eden Outpatient

  • Community/Behavioral Health Agency
  • San Leandro, CA
  • NPI 1023140787
  NPD
• County of Alameda

  dba Alameda Clinic

  • Community/Behavioral Health Agency
  • Alameda, CA
  • NPI 1548392145
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1231891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1013154970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 JACKSON ST",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945441530",
            "telephone_number": "510-891-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 JACKSON ST",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945441530",
            "telephone_number": "510-891-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIGHTELL",
        "first_name": "JEREMY",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-14",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW93817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wen Ching Liao
• Vinson Lieu, DC
• Life Chiropractic College West
• Life House Recovery Homes, Inc.
• Lifelong Medical Care
• Jane Lim
• Joanne Lim
• Valerie A Lim, O.D.
• Natalie Limm, M.S., LEP
• Darlene Daling Lin, MD

• Clinical Social Worker in Hayward, CA
• Providers in Hayward, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.