Active NPI
Laura A Nelson, LSCSW
- Clinical Social Worker
- Fresno, CA
National Provider Identifier
1386988640
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW61774
- Practice address
- 5843 W Swift Ave
Fresno, CA 93722-0465 - Phone
- (904) 483-0375
- NPI assigned
- Nov 26, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 3731 | KS | |
| Clinical Social Worker | 1041C0700X | LCSW61774 | CA | Primary |
Addresses
Primary practice location
5843 W Swift Ave
Fresno, CA 93722-0465
Mailing address
5843 W Swift Ave
Fresno, CA 93722-0465
Phone (904) 483-0375
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3731 | Other | KS | BEHAVIORAL SCIENCES REGULATORY BOARD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW61774 | CA | MD | Clinical Social Worker |
| 3731 | KS | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1353888000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675728000000",
"number": "1386988640",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5843 W SWIFT AVE",
"city": "FRESNO",
"state": "CA",
"postal_code": "937220465",
"telephone_number": "904-483-0375"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5843 W SWIFT AVE",
"city": "FRESNO",
"state": "CA",
"postal_code": "937220465",
"telephone_number": "904-483-0375"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "LAURA",
"middle_name": "A",
"credential": "LSCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-11-26",
"last_updated": "2023-02-07",
"certification_date": "2023-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "KS",
"license": "3731",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCSW61774",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BEHAVIORAL SCIENCES REGULATORY BOARD",
"identifier": "3731",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.