Organization Active NPI

Drews Place Psychotherapy Services, Inc.

  • Clinical Social Worker
  • Redding, CA
National Provider Identifier
1073272928
Registry record updated Dec 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
DREWS PLACE PSYCHOTHERAPY SERVICES, INC.
Practice address
1388 Court St
Redding, CA 96001-1660
Phone
(530) 338-1452
NPI assigned
Dec 8, 2021
Last updated
Dec 21, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2021

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

Authorized official

Name
Staci Bertagna, LCSWNPI 1689098147
Title
Co-Owner
Phone
(530) 338-1452

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X NU
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

1388 Court St
Redding, CA 96001-1660

Mailing address

1388 Court St
Redding, CA 96001-1660
Phone (530) 338-1452

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220114000104 CA Part B Supplier - Clinic/Group Practice 3476945833 Receives reassigned benefits from 3 practitioners
Practice locations: Redding, CA

National Provider Directory

National Provider Directory

Locations

1388 Court St
Redding, CA 96001
Phone (530) 338-1452

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1638921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640044800000",
    "number": "1073272928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1388 COURT ST",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960011660",
            "telephone_number": "530-338-1452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1388 COURT ST",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960011660",
            "telephone_number": "530-338-1452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DREWS PLACE PSYCHOTHERAPY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-08",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A",
        "authorized_official_last_name": "BERTAGNA",
        "authorized_official_first_name": "STACI",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "530-338-1452",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.