Individual provider Active NPI

Han Li, LCSW

  • Mental Health Counselor
  • Mammoth Lakes, CA
National Provider Identifier
1326386830
Registry record updated May 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
26329 Issued in CA
Practice address
1290 Tavern Rd
Mammoth Lakes, CA 93546-6601
Phone
(760) 924-1760
NPI assigned
Jan 18, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 26329 CA Primary

Addresses

Primary practice location

1290 Tavern Rd
Mammoth Lakes, CA 93546-6601

Mailing address

1290 Tavern Rd
Mammoth Lakes, CA 93546-6601
Phone (760) 924-1740

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
I20200618002329 CA Practitioner - Clinical Social Worker 4789006800 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of MonoGroup PAC ID 8527045665, 2 clinicians

Practice addresses (Care Compare)

1290 Tavern Rd
Mammoth Lakes, CA 93546-6601
Phone (760) 924-1700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26329CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
County of Mono CurrentSince Jun 4, 2023 Accepting new patients
Mono County Behavioral Health CurrentSince Jun 4, 2023 Accepting new patients

Locations

1290 Tavern Rd
Mammoth Lakes, CA 93546
Phone (760) 924-1740

Organizations & group practices 2

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": "1358467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1326386830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1290 TAVERN RD",
            "city": "MAMMOTH LAKES",
            "state": "CA",
            "postal_code": "935466601",
            "telephone_number": "760-924-1740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1290 TAVERN RD",
            "city": "MAMMOTH LAKES",
            "state": "CA",
            "postal_code": "935466601",
            "telephone_number": "760-924-1760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LI",
        "first_name": "HAN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-18",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "26329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mammoth Lakes, CA

Sources for this page

Verify at the official NPI Registry.