Individual provider Active NPI

Peter Richard Myers, LCSW

  • Clinical Social Worker
  • Redding, CA
National Provider Identifier
1386734341
Registry record updated Mar 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
88898 Issued in CA
Practice address
1401 Gold St
Redding, CA 96001-1937
Phone
(530) 238-7133
NPI assigned
Oct 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 88898 CA Primary
Clinical Social Worker 1041C0700X 15195 MN

Addresses

Primary practice location

1401 Gold St
Redding, CA 96001-1937

Mailing address

322 E 48TH St
Minneapolis, MN 55419-5649
Phone (612) 825-5472

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
I20240920002651 CA Practitioner - Clinical Social Worker 6608976204 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lumen Health and Psychological Services Inc.Group PAC ID 5799012266, 26 clinicians

Practice addresses (Care Compare)

8421 Auburn Blvd
Suite 110
Citrus Heights, CA 95610-0392
Phone (916) 531-8359

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
88898CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Lumen Health and Psychological Services Inc. CurrentSince Aug 12, 2024 Accepting new patients

Locations

8421 Auburn Blvd
Ste 110
Citrus Heights, CA 95610
Phone (800) 464-4709

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1386734341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 E 48TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554195649",
            "telephone_number": "612-825-5472",
            "fax_number": "651-222-2412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 GOLD ST",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960011937",
            "telephone_number": "530-238-7133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "PETER",
        "middle_name": "RICHARD",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "88898",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "15195",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

Verify at the official NPI Registry.