Individual provider Active NPI

Lila Samady, LCSW

  • Clinical Social Worker
  • Riverside, CA
National Provider Identifier
1033211610
Registry record updated Dec 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW 26395 Issued in CA
Practice address
769 W Blaine St
Riverside, CA 92507-3970
Phone
(951) 358-6895
NPI assigned
Sep 2, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW 26395 CA Primary

Addresses

Primary practice location

769 W Blaine St
Riverside, CA 92507-3970

Mailing address

769 W Blaine St
Riverside, CA 92507-3970

Other identifiers 1

IdentifierTypeStateIssuer
LCSW 26395OtherCACALIFORNIA BOARD OF BEHAVIORAL SCIENCES

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20201211001667 CA Practitioner - Clinical Social Worker 8729490925 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
May accept Medicare assignment
Group practices
Brighter BeginningsGroup PAC ID 8820274699, 12 clinicians

Practice addresses (Care Compare)

2727 Macdonald Ave
Richmond, CA 94804-3006
Phone (510) 236-6990

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW 26395CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lifelong Medical Care CurrentSince Dec 8, 2020 Accepting new patients
Lifelong Medical Care CurrentSince Dec 8, 2020 Accepting new patients
Brighter Beginnings CurrentSince Aug 1, 2024 Accepting new patients
Brighter Beginnings CurrentSince Aug 1, 2024 Accepting new patients

Locations

2344 6th St
Berkeley, CA 94710
Phone (510) 981-3203

10700 MacArthur Blvd
Ste 14B
Oakland, CA 94605
Phone (510) 563-4300

2727 Macdonald Ave
Richmond, CA 94804
Phone (510) 213-6681

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292371200000",
    "number": "1033211610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "769 W BLAINE ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925073970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "769 W BLAINE ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925073970",
            "telephone_number": "951-358-6895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMADY",
        "first_name": "LILA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-02",
        "last_updated": "2010-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW 26395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA BOARD OF BEHAVIORAL SCIENCES",
            "identifier": "LCSW 26395",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.