Lisa Lanelle Wyly, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCS115572 Issued in CA

Practice address

6412 Laurel Ave
Lake Isabella, CA 93240-9529

Phone

(760) 417-1932

NPI assigned

Feb 27, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kern Valley Healthcare DistrictGroup PAC ID 8628069689, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• FHIR API: https://fhir-usa.unify.chbase.com/org/kernvh-26e64ef3

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.

• Kern Valley Healthcare District

  • Critical Access Hospital
  • Lake Isabella, CA
  • NPI 1427049964
  Medicare reassignment Care Compare group NPD
• Heather Berry Counseling, Inc

  • Clinical Social Worker
  • Wofford Heights, CA
  • NPI 1033621610
  NPD
• Kern Valley Healthcare District

  • Rural Health Clinic/Center
  • Mt Mesa, CA
  • NPI 1457854192
  NPD
• Riverstone Wellness, NP

  • Clinical Social Worker
  • Kernville, CA
  • NPI 1780309757
  NPD

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744934400000",
    "number": "1770610040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 363",
            "city": "WOFFORD HEIGHTS",
            "state": "CA",
            "postal_code": "93285",
            "telephone_number": "760-417-1932",
            "fax_number": "760-376-3034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6412 LAUREL AVE",
            "city": "LAKE ISABELLA",
            "state": "CA",
            "postal_code": "932409529",
            "telephone_number": "760-417-1932"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14 Sierra Drive",
            "address_purpose": "LOCATION",
            "city": "Kernville",
            "state": "CA",
            "postal_code": "93238",
            "country_code": "US",
            "telephone_number": "760-417-1932",
            "fax_number": "760-376-3034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WYLY",
        "first_name": "LISA",
        "middle_name": "LANELLE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2025-04-18",
        "certification_date": "2025-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "C8528805",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW98599",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS115572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jackylin Jill Wallace
• Robert Roseburry Weigel Jr.
• Jett Williams
• Wesley Allen Williams, D.C.
• Kimberly Kay Word
• A Ram Yoon

• Clinical Social Worker in Lake Isabella, CA
• Providers in Lake Isabella, 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 Apr 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.