Active NPI
Lloyd Edward Wells Jr., LCSW
- Clinical Social Worker
- Oakland, CA
National Provider Identifier
1568514859
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 91580
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801983960 | Other | CA | ICM |
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 |
|---|---|---|---|
| 91580 | CA | MD | Clinical Social Worker |
| ASW65109 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Foresight Mental Health | 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": "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.