Individual provider Active NPI

Rachel Coffman, LCSW

  • Clinical Social Worker
  • Reno, NV
National Provider Identifier
1053428524
Registry record updated Apr 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4147-C Issued in NV
Practice address
890 Mill St Ste 400
Reno, NV 89502-1562
Phone
(775) 538-6700
NPI assigned
Aug 23, 2006
Last updated
Apr 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2022

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 4147-C NV Primary

Addresses

Primary practice location

890 Mill St Ste 400
Reno, NV 89502-1562

Mailing address

890 Mill St Ste 400
Reno, NV 89502-1562

Other identifiers 1

IdentifierTypeStateIssuer
100510755MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20210326002307 NV Practitioner - Clinical Social Worker 5799192308 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4147-CNVMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Fundamental Behavioral Services LLC CurrentSince Dec 1, 2022 Accepting new patients
Medtrans Medical Nevada Casal PLLC CurrentSince Mar 1, 2021 Accepting new patients
Homebase Care Casal PLLC CurrentSince Mar 1, 2021 Accepting new patients

Locations

3035 S Maryland Pkwy
Ste 110
Las Vegas, NV 89109
Phone (702) 751-2547

3312 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 410-7825

5412 Boulder Hwy
Las Vegas, NV 89122
Phone (702) 383-2406

850 Mill St
Ste 100
Reno, NV 89502
Phone (775) 982-3950

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649980800000",
    "number": "1053428524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "890 MILL ST STE 400",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 MILL ST STE 400",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021562",
            "telephone_number": "775-538-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COFFMAN",
        "first_name": "RACHEL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-23",
        "last_updated": "2022-04-15",
        "certification_date": "2022-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "4147-C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100510755",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.