Wanda Fay Cossairt, LCSW

Individual provider Active NPI Clinical Social Worker · Red Bluff, CA

NPI 1861577751 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1861577751
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
LCS21463 (CA)
Practice address
1860 Walnut St
Suite a
Red Bluff, CA 96080-3611
Phone
(530) 527-5631
Fax
(530) 527-0232
NPI assigned
Oct 26, 2006
Sex
Female
Sole proprietor
Yes

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LCS21463CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Tehama County Past Accepting new patients
County of Tehama Past
since Sep 1, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCS21463 CA Yes

Addresses

Primary practice location

1860 Walnut St
Suite a
Red Bluff, CA 96080-3611

Mailing address

PO Box 400
Red Bluff, CA 96080-0400
Phone (530) 527-5631

Other providers in Red Bluff, CA

All providers in Red Bluff, CA · Clinical Social Worker in California

Sources for this page

Verify at the official NPI Registry.