Individual provider Active NPI

Janet Lee Rainville, LCSW

  • Clinical Social Worker
  • Mount Shasta, CA
National Provider Identifier
1245446855
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS 12344 Issued in CA
Practice address
709 Davis Place Rd
Mount Shasta, CA 96067-9019
Phone
(530) 261-0840
Fax
(530) 918-9035
NPI assigned
May 14, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

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 12344 CA Primary

Addresses

Primary practice location

709 Davis Place Rd
Mount Shasta, CA 96067-9019

Mailing address

709 Davis Place Rd
Mount Shasta, CA 96067-9019
Phone (530) 261-0840

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20090115000231 CA Practitioner - Clinical Social Worker 4284797333 Practice locations: Mount Shasta, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

705 Pine St
Mount Shasta, CA 96067-2133
Phone (530) 261-0840

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS 12344CAMDClinical Social Worker
12344CAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1245446855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 DAVIS PLACE RD",
            "city": "MOUNT SHASTA",
            "state": "CA",
            "postal_code": "960679019",
            "telephone_number": "530-261-0840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 DAVIS PLACE RD",
            "city": "MOUNT SHASTA",
            "state": "CA",
            "postal_code": "960679019",
            "telephone_number": "530-261-0840",
            "fax_number": "530-918-9035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAINVILLE",
        "first_name": "JANET",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-14",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 12344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Shasta, CA

Sources for this page

Verify at the official NPI Registry.