Individual provider Active NPI

Lloyd Edward Wells Jr., LCSW

  • Clinical Social Worker
  • Oakland, CA
National Provider Identifier
1568514859
Registry record updated Oct 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
91580 Issued in CA
Practice address
55 Santa Clara Ave Ste 200
Oakland, CA 94610-1319
Phone
(888) 588-8995
Fax
(510) 756-0812
NPI assigned
Jan 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X ASW65109 CA
Clinical Social Worker 1041C0700X 91580 CA Primary

Addresses

Primary practice location

55 Santa Clara Ave Ste 200
Oakland, CA 94610-1319

Mailing address

1600 Grand Ave Apt 11
San Leandro, CA 94577-5357
Phone (415) 793-4130

Other practice location 1

1000 G St Ste 125
Sacramento, CA 95814-0894
Phone (888) 588-8995

Other identifiers 1

IdentifierTypeStateIssuer
1801983960OtherCAICM

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
91580CAMDClinical Social Worker
ASW65109CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Foresight Mental Health Clinical PastSince Nov 19, 2023 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": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696809600000",
    "number": "1568514859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 GRAND AVE APT 11",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945775357",
            "telephone_number": "415-793-4130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 SANTA CLARA AVE STE 200",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946101319",
            "telephone_number": "888-588-8995",
            "fax_number": "510-756-0812"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 G St Ste 125",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958140894",
            "country_code": "US",
            "telephone_number": "888-588-8995",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WELLS",
        "first_name": "LLOYD",
        "middle_name": "EDWARD",
        "name_suffix": "Jr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW65109",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "91580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ICM",
            "identifier": "1801983960",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2023; 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.