Individual provider Active NPI

Mindy Lauerlevin, LCSW

  • Clinical Social Worker
  • Orange, CA
National Provider Identifier
1497875637
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LIC 19838 Issued in CA
Practice address
1745 W Orangewood Ave Ste 101
Orange, CA 92868-2041
Phone
(714) 301-4544
Fax
(714) 633-7766
NPI assigned
Mar 30, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 LIC 19838 CA Primary

Addresses

Primary practice location

1745 W Orangewood Ave Ste 101
Orange, CA 92868-2041

Mailing address

1745 W Orangewood Ave Ste 101
Orange, CA 92868-2041

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

LicenseStateTypeSpecialty
LIC 19838CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497875637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1745 W ORANGEWOOD AVE STE 101",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928682041",
            "fax_number": "714-633-7766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1745 W ORANGEWOOD AVE STE 101",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928682041",
            "telephone_number": "714-301-4544",
            "fax_number": "714-633-7766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUERLEVIN",
        "first_name": "MINDY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LIC 19838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.