Individual provider Active NPI

Chelsea Trujillo, LCSW

  • Clinical Social Worker
  • Gresham, OR
National Provider Identifier
1013376060
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L11628 Issued in OR
Practice address
1700 NW Civic Dr Ste 310
Gresham, OR 97030-3774
Phone
(503) 666-8832
NPI assigned
Feb 18, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Clinical Social Worker 1041C0700X L11628 OR Primary

Addresses

Primary practice location

1700 NW Civic Dr Ste 310
Gresham, OR 97030-3774

Mailing address

1700 NW Civic Dr Ste 310
Gresham, OR 97030-3774

Other practice location 1

504 Villa Rd
Suite 3
Newberg, OR 97132-1851
Phone (503) 538-4874

Other practice location 2

435 NE Evans St Ste A
McMinnville, OR 97128-4628
Phone (503) 472-4020

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: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2910 S 7TH Way
Ridgefield, WA 98642-1909

348 W Adams St
Burns, OR 97720-1710

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L11628ORMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lutheran Community Services Northwest CurrentSince Feb 19, 2023 Accepting new patients
Chehalem Youth & Family Services PastSince Jul 24, 2022 Accepting new patients
Chehalem Youth & Family Services Past Accepting new patients

Locations

435 NE Evans St
Ste A
McMinnville, OR 97128
Phone (503) 472-4020

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1455753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1013376060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 NW CIVIC DR STE 310",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 NW CIVIC DR STE 310",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303774",
            "telephone_number": "503-666-8832"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "504 Villa Rd",
            "address_2": "Suite 3",
            "address_purpose": "LOCATION",
            "city": "Newberg",
            "state": "OR",
            "postal_code": "971321851",
            "country_code": "US",
            "telephone_number": "503-538-4874",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "435 NE Evans St Ste A",
            "address_purpose": "LOCATION",
            "city": "McMinnville",
            "state": "OR",
            "postal_code": "971284628",
            "country_code": "US",
            "telephone_number": "503-472-4020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRUJILLO",
        "first_name": "CHELSEA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-18",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L11628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

Verify at the official NPI Registry.