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LARISSA ANNE PENDERGRAFT LCSW
NPI 1932404902
Social Worker - Clinical in Windsor, CA

Active since January 21, 2011PECOS Enrolled
9240 OLD REDWOOD HWY STE 267, WINDSOR, CA 95492(707) 565-7801 Get Directions Write a Review

NPPES record last updated: July 19, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 19, 2022, Sep 30, 2021 (2 updates tracked since 2021).

About Larissa Anne Pendergraft Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LARISSA ANNE PENDERGRAFT LCSW (NPI 1932404902) is an individual clinical provider in Windsor, California, licensed in California (63962) and active in the NPI registry since January 2011. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1932404902
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameLARISSA ANNE PENDERGRAFTCredential: LCSW
Location Address9240 OLD REDWOOD HWY STE 267Windsor, CA 95492-9348
Mailing Address1207 S Fitch Mountain RdHealdsburg, CA 95448-4612
Phone(707) 565-7801
Sole ProprietorYes
Enumeration DateJanuary 21, 2011
Last NPPES UpdateJuly 19, 20222 updates tracked since enumeration
NPPES CertifiedJuly 19, 2022
✔ NPI 1932404902 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in CA · 63962
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Also ListedSocial WorkerTaxonomy 104100000X · License 24712 (CA)
9240 OLD REDWOOD HWY STE 267, Windsor, CA 95492
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Larissa Anne Pendergraft Lcsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Larissa Pendergraft reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

County Of Sonoma
7.7 mi
Mental Health (Including Community Mental Health Center)
2350 PROFESSIONAL DR
Santa Rosa, CA 95403
  • Reassigned Medicare billing, California enrollment
  • 64 clinicians in this Medicare group
NPI 1952515462 (707) 565-4850

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95492 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $63.04 – $187.01
Typical copayment $0.00 (range $15.76 – $46.75)
Most-billed visit code NA
Established Patient
$77.94 typical visit price
range $21.02 – $153.40
Typical copayment $19.48 (range $5.25 – $38.35)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Larissa Pendergraft's NPI number?

The NPI number for Larissa Pendergraft is 1932404902. It was assigned to this individual provider in the NPPES registry on January 21, 2011.

Where is Larissa Pendergraft located?

Larissa Pendergraft practices at 9240 Old Redwood Hwy Ste 267, Windsor, CA 95492. The listed phone number is (707) 565-7801.

What is Larissa Pendergraft's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Larissa Pendergraft enrolled in Medicare?

Yes. Larissa Pendergraft is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Larissa Pendergraft's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Larissa Pendergraft reassigns Medicare benefits to County Of Sonoma (Santa Rosa, 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 Larissa Pendergraft'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 Larissa Pendergraft was last updated on July 19, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.