Active NPI
Lynnette Marie Wilhardt, LCSW
- Clinical Social Worker
- Costa Mesa, CA
National Provider Identifier
1114228905
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS16597
- Practice address
- 151 Kalmus Dr Ste C245
Costa Mesa, CA 92626-7954 - Phone
- (714) 417-1171
- NPI assigned
- Nov 9, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCS16597 | CA | Primary |
Addresses
Primary practice location
151 Kalmus Dr Ste C245
Costa Mesa, CA 92626-7954
Mailing address
PO Box 5245
Balboa Island, CA 92662-5245
Phone (714) 417-1171
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective May 22, 2023 through May 22, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16597 | CA | MD | Professional Counselor |
| LCS16597 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1289260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1289260800000",
"number": "1114228905",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5245",
"city": "BALBOA ISLAND",
"state": "CA",
"postal_code": "926625245",
"telephone_number": "714-417-1171"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "151 KALMUS DR STE C245",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926267954",
"telephone_number": "714-417-1171"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILHARDT",
"first_name": "LYNNETTE",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-11-09",
"last_updated": "2010-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS16597",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Costa Mesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.