Active NPI
Charlene Lau, LCSW
- Clinical Social Worker
- Irvine, CA
National Provider Identifier
1982421756
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW96645
- Practice address
- 16250 Sand Canyon Ave
Irvine, CA 92618-3714 - Phone
- (949) 614-5518
- NPI assigned
- Sep 24, 2024
- Last updated
- Sep 24, 2024
- 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 | LCSW96645 | CA | Primary |
Addresses
Primary practice location
16250 Sand Canyon Ave
Irvine, CA 92618-3714
Mailing address
15090 Kensington Park Dr
Ste 430 PMB #27
Tustin, CA 92782
Phone (949) 614-5518
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW96645 | CA | MD | Clinical Social Worker |
| 96645 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brainiac Medical Corporation | Clinical | Current | Accepting new patients |
Locations
1101 California Ave
Ste 10018
Corona, CA 92881
Phone (714) 712-0711
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, 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": "1727136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727136000000",
"number": "1982421756",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15090 KENSINGTON PARK DR",
"address_2": "STE 430 PMB #27",
"city": "TUSTIN",
"state": "CA",
"postal_code": "92782",
"telephone_number": "949-614-5518"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16250 SAND CANYON AVE",
"city": "IRVINE",
"state": "CA",
"postal_code": "926183714",
"telephone_number": "949-614-5518"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAU",
"first_name": "CHARLENE",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-09-24",
"last_updated": "2024-09-24",
"certification_date": "2024-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCSW96645",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Irvine, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.