Individual provider Active NPI

Laura Nelson, LCSW

  • Clinical Social Worker
  • El Cerrito, CA
National Provider Identifier
1174628598
Registry record updated Jan 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
25013 Issued in CA
Practice address
406 Colusa Ave.
El Cerrito, CA 94530
Phone
(510) 725-9240
NPI assigned
Sep 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2009

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 25013 CA Primary

Addresses

Primary practice location

406 Colusa Ave.
El Cerrito, CA 94530

Mailing address

1953 Napa Ave
Berkeley, CA 94707-2607
Phone (510) 725-9240

Other identifiers 1

IdentifierTypeStateIssuer
11575832OtherCAQH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25013CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Saffron Behavioral Health and Psychology PastSince Oct 15, 2023 Accepting new patients

Organizations & group practices 1

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": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232409600000",
    "number": "1174628598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1953 NAPA AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947072607",
            "telephone_number": "510-725-9240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 COLUSA AVE.",
            "city": "EL CERRITO",
            "state": "CA",
            "postal_code": "94530",
            "telephone_number": "510-725-9240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "LAURA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2009-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "25013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11575832",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Cerrito, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.