Individual provider Active NPI

Lori Eberly, LCSW

  • Clinical Social Worker
  • Portland, OR
National Provider Identifier
1003664012
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L4039 Issued in OR
Practice address
500 NE Multnomah St FL 7
Portland, OR 97232-2023
Phone
(503) 499-5200
NPI assigned
May 7, 2024
Last updated
May 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X L4039 OR Primary

Addresses

Primary practice location

500 NE Multnomah St FL 7
Portland, OR 97232-2023

Mailing address

7865 N Washburne Ave
Portland, OR 97217-5945

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
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L4039ORMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1715040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1003664012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7865 N WASHBURNE AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972175945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 NE MULTNOMAH ST FL 7",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322023",
            "telephone_number": "503-499-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERLY",
        "first_name": "LORI",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-07",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L4039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.