Individual provider Active NPI

Henry Lugo Meraz Jr., LCSW

  • Clinical Social Worker
  • Fresno, CA
National Provider Identifier
1396041232
Registry record updated Jul 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
72943 Issued in CA
Practice address
6777 N Willow Ave
Fresno, CA 93710-5900
Phone
(559) 824-3779
Fax
(559) 705-1936
NPI assigned
Feb 9, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 72943 CA
Clinical Social Worker 1041C0700X 72943 CA Primary

Addresses

Primary practice location

6777 N Willow Ave
Fresno, CA 93710-5900

Mailing address

8616 N Garden Ave
Fresno, CA 93720-3975
Phone (559) 824-3779

Other identifiers 1

IdentifierTypeStateIssuer
800677527MedicaidCA

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
I20161206001353 CA Practitioner - Clinical Social Worker 7517247760 Practice locations: Fresno, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
72943CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Safe and Affirmative Counseling, Licensed Clinical Social Worker, Inc Mental Health CurrentSince Dec 15, 2019 Accepting new patients

Locations

6777 N Willow Ave
Fresno, CA 93710
Phone (559) 261-2999

7555 N Del Mar Ave
Ste 206
Fresno, CA 93711
Phone (559) 500-6744

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": "1297209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564444800000",
    "number": "1396041232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8616 N GARDEN AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203975",
            "telephone_number": "559-824-3779",
            "fax_number": "559-705-1936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6777 N WILLOW AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937105900",
            "telephone_number": "559-824-3779",
            "fax_number": "559-705-1936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERAZ",
        "first_name": "HENRY",
        "middle_name": "LUGO",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-02-09",
        "last_updated": "2019-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "72943",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "72943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "800677527",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.