Active NPI
Lynette Redal Stime
- Clinical Social Worker
- Modesto, CA
National Provider Identifier
1487142121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS12504
- Practice address
- 1213 Coffee Rd Ste P
Modesto, CA 95355-4229 - Phone
- (209) 527-8943
- NPI assigned
- Apr 27, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCS12504 | CA | Primary |
Addresses
Primary practice location
1213 Coffee Rd Ste P
Modesto, CA 95355-4229
Mailing address
1213 Coffee Rd Ste P
Modesto, CA 95355-4229
Phone (209) 527-8943
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 |
|---|---|---|---|
| LCS12504 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Downey Park Counseling Associates | Clinical | Past | Accepting new patients |
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": "1524787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1524787200000",
"number": "1487142121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1213 COFFEE RD STE P",
"city": "MODESTO",
"state": "CA",
"postal_code": "953554229",
"telephone_number": "209-527-8943"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1213 COFFEE RD STE P",
"city": "MODESTO",
"state": "CA",
"postal_code": "953554229",
"telephone_number": "209-527-8943"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STIME",
"first_name": "LYNETTE",
"middle_name": "REDAL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-04-27",
"last_updated": "2018-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS12504",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.