Active NPI
Laura Gay Levin, LCSW
- Clinical Social Worker
- Santa Rosa, CA
National Provider Identifier
1912411760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 20253
- Practice address
- 825 College Ave
Santa Rosa, CA 95404-4108 - Phone
- (707) 217-1398
- NPI assigned
- Nov 30, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 20253 | CA | Primary |
Addresses
Primary practice location
825 College Ave
Santa Rosa, CA 95404-4108
Mailing address
825 College Ave Ste 9
Santa Rosa, CA 95404-4108
Phone (707) 217-1398
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Sep 17, 2022 through Sep 17, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1512000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1512000000000",
"number": "1912411760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "825 COLLEGE AVE STE 9",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954044108",
"telephone_number": "707-217-1398"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "825 COLLEGE AVE",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954044108",
"telephone_number": "707-217-1398"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEVIN",
"first_name": "LAURA",
"middle_name": "GAY",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-11-30",
"last_updated": "2017-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "20253",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Rosa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.