Individual provider Active NPI

Lawrence D Perea

  • Clinical Social Worker
  • Laramie, WY
National Provider Identifier
1851931919
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1570 Issued in WY
Practice address
502 S 4TH St
Laramie, WY 82070-3704
Phone
(307) 755-1000
NPI assigned
Jan 7, 2020
Last updated
Jul 15, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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 1570 WY Primary

Addresses

Primary practice location

502 S 4TH St
Laramie, WY 82070-3704

Mailing address

502 S 4TH St
Laramie, WY 82070-3704
Phone (307) 755-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
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
I20240826001173 WY Practitioner - Clinical Social Worker 1456890292 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

502 S 4TH St
Laramie, WY 82070-3704
Phone (307) 399-7145

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1570WYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Empower Counseling LLC Clinical Current Accepting new patients

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, 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": "1578355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1851931919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 S 4TH ST",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820703704",
            "telephone_number": "307-755-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 S 4TH ST",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820703704",
            "telephone_number": "307-755-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREA",
        "first_name": "LAWRENCE",
        "middle_name": "D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-07",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WY",
            "license": "1570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laramie, WY

Sources for this page

Verify at the official NPI Registry.