Individual provider Active NPI

Wendy Lewis, LCSW

  • Clinical Social Worker
  • Granite Bay, CA
National Provider Identifier
1245241371
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS 18428 Issued in CA
Practice address
9700 Village Center Dr Ste 210
Granite Bay, CA 95746-6310
Phone
(916) 597-0775
NPI assigned
Aug 11, 2006
Last updated
Feb 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2025

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 LCS 18428 CA Primary

Addresses

Primary practice location

9700 Village Center Dr Ste 210
Granite Bay, CA 95746-6310

Mailing address

9700 Village Center Dr Ste 210
Granite Bay, CA 95746-6310
Phone (916) 597-0775

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jan 1, 2020 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS 18428CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
James Meyer Clinical Past 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, 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": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1245241371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9700 VILLAGE CENTER DR STE 210",
            "city": "GRANITE BAY",
            "state": "CA",
            "postal_code": "957466310",
            "telephone_number": "916-597-0775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9700 VILLAGE CENTER DR STE 210",
            "city": "GRANITE BAY",
            "state": "CA",
            "postal_code": "957466310",
            "telephone_number": "916-597-0775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "WENDY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS  18428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Granite Bay, CA

Sources for this page

Verify at the official NPI Registry.