Individual provider Active NPI

Lenwood Valentino Patterson

  • Clinical Social Worker
  • Long Beach, CA
National Provider Identifier
1831387067
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
512 Redondo Ave # C-1
Long Beach, CA 90814-1552
Phone
(213) 675-9016
Fax
(323) 563-9333
NPI assigned
Oct 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X LCSW69529 CA
Social Worker 104100000X ASW26884 CA
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

512 Redondo Ave # C-1
Long Beach, CA 90814-1552

Mailing address

1900 E Ocean Blvd Apt 1406
Long Beach, CA 90802-6139
Phone (213) 675-9016

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
I20160602002374 CA Practitioner - Clinical Social Worker 5395035364 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1703 Termino Ave
Suite 105
Long Beach, CA 90804-2126
Phone (213) 675-9016

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ASW26884CAMDSocial Worker
LCSW69529CAMDSocial Worker
69529CAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Organizations & group practices 1

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": "1192147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1831387067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 E OCEAN BLVD APT 1406",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908026139",
            "telephone_number": "213-675-9016",
            "fax_number": "323-563-9333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 REDONDO AVE # C-1",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908141552",
            "telephone_number": "213-675-9016",
            "fax_number": "323-563-9333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "LENWOOD",
        "middle_name": "VALENTINO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-12",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "LCSW69529",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "ASW26884",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.