Individual provider Active NPI

Roger Milton Slagle, MFA LCSW

  • Clinical Social Worker
  • Redding, CA
National Provider Identifier
1811344450
Registry record updated Aug 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW10885 Issued in CA
Practice address
999 Mission de Oro Dr Ste 103
Redding, CA 96003
Phone
(530) 605-0189
Fax
(530) 605-4428
NPI assigned
May 23, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2019

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 LCSW10885 CA Primary

Addresses

Primary practice location

999 Mission de Oro Dr Ste 103
Redding, CA 96003

Mailing address

8570 Savannah Way
Shingletown, CA 96088-9308
Phone (530) 646-7778

Other practice location 1

1304 East St Ste 220
Redding, CA 96001
Phone (530) 605-0189

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
I20180308002368 CA Practitioner - Clinical Social Worker 7214298116 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1510 Hartnell Ave
Suite B
Redding, CA 96002-2278
Phone (530) 605-0189

3330 Churn Creek Rd
Suite B1
Redding, CA 96002-2532

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Fine Arts

State licenses

LicenseStateTypeSpecialty
LCSW10885CAMDClinical Social Worker
10885CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Redding Alternatives, Inc. CurrentSince May 25, 2018 Accepting new patients
Creekside Counseling Center Inc PastSince Sep 14, 2020 Accepting new patients

Locations

1510 Hartnell Ave
Ste B
Redding, CA 96002
Phone (530) 605-0189

999 Mission de Oro Dr
Ste 103
Redding, CA 96003
Phone (530) 605-0189

1304 East St
Ste 220
Redding, CA 96001
Phone (530) 605-0189

Organizations & group practices 2

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": "1463961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567036800000",
    "number": "1811344450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8570 SAVANNAH WAY",
            "city": "SHINGLETOWN",
            "state": "CA",
            "postal_code": "960889308",
            "telephone_number": "530-646-7778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 MISSION DE ORO DR STE 103",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "96003",
            "telephone_number": "530-605-0189",
            "fax_number": "530-605-4428"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1304 East St Ste 220",
            "address_purpose": "LOCATION",
            "city": "Redding",
            "state": "CA",
            "postal_code": "96001",
            "country_code": "US",
            "telephone_number": "530-605-0189",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SLAGLE",
        "first_name": "ROGER",
        "middle_name": "MILTON",
        "credential": "MFA LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-23",
        "last_updated": "2019-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW10885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

Verify at the official NPI Registry.