Active NPI
Elise Travertini, LCSW
- Clinical Social Worker
- Medford, OR
National Provider Identifier
1023326659
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- L4519
- Practice address
- 3617 S Pacific Hwy
Medford, OR 97501-8957 - Phone
- (541) 535-6239
- Fax
- (541) 535-4377
- NPI assigned
- Sep 16, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | L4519 | OR | Primary |
Addresses
Primary practice location
3617 S Pacific Hwy
Medford, OR 97501-8957
Mailing address
931 Chevy Way
Medford, OR 97504-4127
Phone (541) 690-3555
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L4519 | OR | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1284595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590105600000",
"number": "1023326659",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "931 CHEVY WAY",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975044127",
"telephone_number": "541-690-3555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3617 S PACIFIC HWY",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975018957",
"telephone_number": "541-535-6239",
"fax_number": "541-535-4377"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRAVERTINI",
"first_name": "ELISE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-16",
"last_updated": "2020-05-22",
"certification_date": "2020-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OR",
"license": "L4519",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.