Individual provider Active NPI

Peter Heck, LCSW

  • Clinical Social Worker
  • Scotia, CA
National Provider Identifier
1629520507
Registry record updated Sep 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW86760 Issued in CA
Practice address
500 B Street
Scotia, CA 95565
Phone
(707) 764-5617
NPI assigned
Oct 26, 2016
Last updated
Sep 16, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 83127 CA
Clinical Social Worker 1041C0700X CSW.09924313 CO
Clinical Social Worker 1041C0700X LCSW-986 WY
Clinical Social Worker 1041C0700X LCSW86760 CA Primary

Addresses

Primary practice location

500 B Street
Scotia, CA 95565

Mailing address

500 B Street
Scotia, CA 95565

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20191010001058 CA Practitioner - Clinical Social Worker 2860769635 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Thrive Psychological Services IncGroup PAC ID 1658744974, 13 clinicians

Practice addresses (Care Compare)

3633 Inland Empire Blvd
Suite 777
Ontario, CA 91764-7974
Phone (909) 295-5805

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW86760CAMDClinical Social Worker
CSW.09924313COMDClinical Social Worker
LCSW-986WYMDClinical Social Worker
83127CAMDPharmacist
86760CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
The Wecare Group, Inc. CurrentSince Jul 27, 2019 Accepting new patients
Thrive Psychological Services Inc CurrentSince Jan 8, 2024 Accepting new patients
Southern Trinity Health Services CurrentSince Jul 27, 2019 Accepting new patients
The Wecare Group, Inc. Past Accepting new patients

Locations

321 Van Duzen Rd
Mad River, CA 95526
Phone (707) 574-6616

3633 Inland Empire Blvd
Ste 777
Ontario, CA 91764
Phone (909) 235-5662

Organizations & group practices 4

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": "1477440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568592000000",
    "number": "1629520507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 B STREET",
            "city": "SCOTIA",
            "state": "CA",
            "postal_code": "95565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 B STREET",
            "city": "SCOTIA",
            "state": "CA",
            "postal_code": "95565",
            "telephone_number": "707-764-5617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HECK",
        "first_name": "PETER",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-26",
        "last_updated": "2019-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "83127",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09924313",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WY",
            "license": "LCSW-986",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW86760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scotia, CA

Sources for this page

Verify at the official NPI Registry.