NPIMap

Organization Active NPI

County of Lake

Doing business as Lake County Behavioral Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Clearlake, CA
National Provider Identifier
1326252271
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
COUNTY OF LAKE
Practice address
7000B S Center Dr
Clearlake, CA 95422-8131
Phone
(707) 994-7090
Fax
(707) 994-7092
NPI assigned
May 10, 2007
Last updated
Aug 10, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Elise Jones, MANPI 1053547034
Title
Behavioral Health Director
Phone
(707) 274-9101

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X CA Primary

Addresses

Primary practice location

7000B S Center Dr
Clearlake, CA 95422-8131

Mailing address

PO Box 1024
Lucerne, CA 95458-1024
Phone (707) 274-9101

Other names 1

  • Lake County Behavioral Health Services Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050609001101 CA Part B Supplier - Clinic/Group Practice 2466495429 Receives reassigned benefits from 16 practitioners
1 other NPI on this enrollment
Practice locations: Clearlake, CA; Lucerne, CA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

  • County of Lake

    dba Lake County Behavioral Health Services

    • Community/Behavioral Health Agency
    • Lucerne, CA
    • NPI 1215140066

    O20050609001101

    Same enrollment

National Provider Directory

National Provider Directory

Locations

7000B S Center Dr
Clearlake, CA 95422
Phone (707) 274-9101

7000B S Center Dr
Unit A
Clearlake, CA 95422

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691625600000",
    "number": "1326252271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1024",
            "city": "LUCERNE",
            "state": "CA",
            "postal_code": "954581024",
            "telephone_number": "707-274-9101",
            "fax_number": "707-274-9192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000B S CENTER DR",
            "city": "CLEARLAKE",
            "state": "CA",
            "postal_code": "954228131",
            "telephone_number": "707-994-7090",
            "fax_number": "707-994-7092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF LAKE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "ELISE",
        "authorized_official_title_or_position": "BEHAVIORAL HEALTH DIRECTOR",
        "authorized_official_telephone_number": "707-274-9101",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake County Behavioral Health Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lake County Behavioral Health Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Clearlake, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.