Active NPI
Debra Rochelle Lyman, LCSW
- Clinical Social Worker
- Oakland, CA
National Provider Identifier
1306860564
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS22113
- Practice address
- 3824 Grand Ave
Oakland, CA 94610-1004 - Phone
- (510) 594-4099
- NPI assigned
- Jul 27, 2006
- Last updated
- Jun 11, 2019
- 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 | LCS22113 | CA | Primary |
Addresses
Primary practice location
3824 Grand Ave
Oakland, CA 94610-1004
Mailing address
3824 Grand Ave
Oakland, CA 94610-1004
Phone (510) 594-4099
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 1, 2024 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCS22113 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560211200000",
"number": "1306860564",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3824 GRAND AVE",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946101004",
"telephone_number": "510-594-4099"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3824 GRAND AVE",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946101004",
"telephone_number": "510-594-4099"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYMAN",
"first_name": "DEBRA",
"middle_name": "ROCHELLE",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-27",
"last_updated": "2019-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS22113",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.