HERTHAO LY LCSW
NPI 1912375676
Counselor - Mental Health in Sacramento, CA
About Herthao Ly Lcsw NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
HERTHAO LY LCSW (NPI 1912375676) is an individual mental health provider in Sacramento, California, licensed in California (104920) and active in the NPI registry since September 2015. He is enrolled in Medicare PECOS and is a graduate of Other (2017).
NPPES Registry Identity
Specialties & Licenses 3
Other Names 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Herthao Ly Lcsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Herthao Ly reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Stockton, CA 95210
- Reassigned Medicare billing, California enrollment
- 20,078 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SACRAMENTO, CA 95823
SACRAMENTO, CA 95823
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Herthao Ly's NPI number?
The NPI number for Herthao Ly is 1912375676. It was assigned to this individual provider in the NPPES registry on September 10, 2015. The provider is also known as Kirby Ly Lcsw.
Where is Herthao Ly located?
Herthao Ly practices at 7300 Wyndham Dr Fl 2, Sacramento, CA 95823. The listed phone number is (916) 525-6207.
What is Herthao Ly's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Herthao Ly enrolled in Medicare?
Yes. Herthao Ly is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Herthao Ly's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Herthao Ly reassigns Medicare benefits to Permanente Medical Group Inc (Stockton, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Herthao Ly's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Herthao Ly was last updated on September 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 51 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Herthao Ly, LCSW · NPI 1912375676
Mental Health provider in Sacramento, California. Individual provider, active in the CMS NPPES registry since September 10, 2015.
## Identity
- **NPI:** 1912375676 (Entity type: Individual)
- **Enumerated:** September 10, 2015
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **State license:** 104920 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 7300 WYNDHAM DR FL 2, Sacramento, CA 95823-4913
- **Phone:** (916) 525-6207
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Permanente Medical Group Inc (NPI 1548343510, Stockton, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2017
## Record status
- **NPPES last updated:** September 11, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1912375676) · Data from the CMS NPPES public registry.