Shelley Wisdom-Lazar, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW61046 Issued in CA

Practice address

1267 Rosecrans St Ste E
San Diego, CA 92106-2692

Phone

(619) 540-7811

Fax

(858) 755-2416

NPI assigned

Feb 13, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Rachelle Wisdom-Lazar Other name

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

Specialty

Clinical Social Worker

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Shelley Wisdom-Lazar Licensed Clinical Social Worker P.C.

  • Clinical Social Worker
  • Del Mar, CA
  • NPI 1699508622
  Medicare reassignment NPD Authorized official
• Joel Lazar, PHD PC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Diego, CA
  • NPI 1770320541
  NPD (past)

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

{
    "created_epoch": "1329091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1467725028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3695",
            "city": "RANCHO SANTA FE",
            "state": "CA",
            "postal_code": "920673695",
            "telephone_number": "619-540-7811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1267 ROSECRANS ST STE E",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921062692",
            "telephone_number": "619-540-7811",
            "fax_number": "858-755-2416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISDOM-LAZAR",
        "first_name": "SHELLEY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-13",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "SW61046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHELLE",
            "last_name": "WISDOM-LAZAR",
            "credential": "LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Tyler Wipf
• Jan Wirsching, RD
• Elyjah Wirth
• Gordon G Wisbach III, M.D
• Briana Wischnack, NP
• Wise Counsel Psychology Inc
• Wise Mind Behavioral Therapy, PLLC
• Wise Self Psychology, Inc.
• Jessica Wise-Graham
• Allison Wise, LCSW

• Clinical Social Worker in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.