Mrs Lisa Lanelle Wyly, ASW is a medicare enrolled "Social Worker - Clinical" provider in Lake Isabella, California. Her current practice location is
6412 Laurel Ave, Lake Isabella, California. You can reach out to her office (for appointments etc.) via phone at
(760) 417-1932.
Mrs Lisa Lanelle Wyly is licensed to practice in California (license number LCS115572) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1770610040.
Healthcare Provider's Profile
| Full Name | Mrs Lisa Lanelle Wyly |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 6412 Laurel Ave, Lake Isabella, California |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1770610040
- Provider Enumeration Date: 02/27/2007
- Last Update Date: 09/01/2023
Medicare PECOS Information:
- PECOS PAC ID: 8628424918
- Enrollment ID: I20231023001956
Medical Identifiers
Medical identifiers for Mrs Lisa Lanelle Wyly such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1770610040 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YA0400X | Counselor - Addiction (substance Use Disorder) | C8528805 (California) | Secondary |
| 1041C0700X | Social Worker - Clinical | ASW98599 (California) | Secondary |
| 1041C0700X | Social Worker - Clinical | LCS115572 (California) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Lisa Lanelle Wyly allows following entities to bill medicare on her behalf.
| Entity Name | Kern Valley Healthcare District |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1427049964
PECOS PAC ID: 8628069689
Enrollment ID: O20040519001345 |
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| Entity Name | Heather Berry Counseling Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1033621610
PECOS PAC ID: 8224396965
Enrollment ID: O20171229001017 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Lisa Lanelle Wyly is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Mrs Lisa Lanelle Wyly, ASW
P.o. Box 363,
Wofford Heights, CA 93285
Ph: (760) 417-1932 | Mrs Lisa Lanelle Wyly, ASW
6412 Laurel Ave,
Lake Isabella, CA 93240-9529
Ph: (760) 417-1932 |
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