Individual provider Active NPI

Lawrence Jesse Carr, C.S.W. INTERN

  • Clinical Social Worker
  • Carson City, NV
National Provider Identifier
1386991214
Registry record updated Aug 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
5827-S Issued in NV
Practice address
775 Fleischmann Way
Carson City, NV 89703-2995
Phone
(775) 445-7373
NPI assigned
Aug 9, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 5827-S NV Primary

Addresses

Primary practice location

775 Fleischmann Way
Carson City, NV 89703-2995

Mailing address

1861 11TH St
Sparks, NV 89431-3014
Phone (775) 331-5364

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20241017001725 NV Practitioner - Clinical Social Worker 6608308457 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5827-SNVMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
CTH Physicians Clinic Current Accepting new patients
Carson Tahoe Physician Clinics CurrentSince Sep 2, 2024 Accepting new patients

Locations

2874 N Carson St
Ste 200
Carson City, NV 89706
Phone (775) 283-3220

775 Fleischmann Way
Fl 2
Carson City, NV 89703
Phone (775) 445-5632

775 Fleischmann Way
Carson City, NV 89703
Phone (775) 445-5632

570 S Maine St
Fallon, NV 89406
Phone (775) 423-9511

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": "1344470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344470400000",
    "number": "1386991214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1861 11TH ST",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894313014",
            "telephone_number": "775-331-5364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 FLEISCHMANN WAY",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897032995",
            "telephone_number": "775-445-7373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARR",
        "first_name": "LAWRENCE",
        "middle_name": "JESSE",
        "credential": "C.S.W. INTERN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-09",
        "last_updated": "2012-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "5827-S",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carson City, NV

Sources for this page

Verify at the official NPI Registry.