Individual provider Active NPI

Ericka L Severs, LCSW

  • Clinical Social Worker
  • North Las Vegas, NV
National Provider Identifier
1629309208
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
5901-C Issued in NV
Practice address
3435 W Craig Rd Ste a
North Las Vegas, NV 89032-5116
Phone
(702) 675-6314
Fax
(702) 476-9697
NPI assigned
Jan 21, 2010
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 5901-C NV Primary

Addresses

Primary practice location

3435 W Craig Rd Ste a
North Las Vegas, NV 89032-5116

Mailing address

3435 W Craig Rd Ste a
North Las Vegas, NV 89032-5116
Phone (702) 675-6314

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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

Enrollment IDStateProvider typePAC IDDetails
I20170427001493 NV Practitioner - Clinical Social Worker 2365729498 Practice locations: North Las Vegas, NV

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
360 Health and Wellness, LLC Current Accepting new patients
Diversified Community Services, CDC PastSince Feb 21, 2017 Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1264032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1629309208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3435 W CRAIG RD STE A",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890325116",
            "telephone_number": "702-675-6314",
            "fax_number": "702-476-9697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3435 W CRAIG RD STE A",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890325116",
            "telephone_number": "702-675-6314",
            "fax_number": "702-476-9697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEVERS",
        "first_name": "ERICKA",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-21",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "5901-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.