Shelley Wisdom-Lazar Licensed Clinical Social Worker P.C.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

SHELLEY WISDOM-LAZAR LICENSED CLINICAL SOCIAL WORKER P.C.

Practice address

445 Marine View Ave Ste 300
Del Mar, CA 92014-3926

Phone

(619) 540-7811

Fax

(858) 755-2416

NPI assigned

Aug 23, 2024

Organization subpart

No

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

Authorized official

Name

Shelley Wisdom-Lazar, LCSWNPI 1467725028

Title

Owner

Phone

(619) 540-7811

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shelley Wisdom-Lazar, LCSW

  • Clinical Social Worker
  • San Diego, CA
  • NPI 1467725028
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1724371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724371200000",
    "number": "1699508622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3695",
            "city": "RANCHO SANTA FE",
            "state": "CA",
            "postal_code": "920673695",
            "telephone_number": "619-540-7811",
            "fax_number": "858-744-2416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 MARINE VIEW AVE STE 300",
            "city": "DEL MAR",
            "state": "CA",
            "postal_code": "920143926",
            "telephone_number": "619-540-7811",
            "fax_number": "858-755-2416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHELLEY WISDOM-LAZAR LICENSED CLINICAL SOCIAL WORKER P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-23",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A",
        "authorized_official_last_name": "WISDOM-LAZAR",
        "authorized_official_first_name": "SHELLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "619-540-7811",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Beth Sfeir Mitzel, LMFT
• Lawrence Power Shank, D.C.
• Sharp Rees-Stealy Medical Group Inc
• Sarah Elizabeth Shead, LCSW CA 112852
• Roger Sheen, PT, DPT
• Kashaf Sherafgan, MD
• Oded R Shezifi, PSY.D
• Natanya Ann Yellin Shiah, IBCLC
• Dana M Shipp, M.D.
• Anaheed Shirazi, MD

• Clinical Social Worker in Del Mar, CA
• Providers in Del Mar, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.