Individual provider Active NPI

Elizabeth Delgros-Ryan, MSW,MPH

  • Clinical Social Worker
  • Salem, OR
National Provider Identifier
1023389970
Registry record updated Jun 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L10746 Issued in OR
Practice address
528 Cottage St NE Ste 401
Salem, OR 97301-3811
Phone
(503) 583-8537
Fax
(503) 343-3331
NPI assigned
Jan 24, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X L10746 OR Primary

Addresses

Primary practice location

528 Cottage St NE Ste 401
Salem, OR 97301-3811

Mailing address

528 Cottage St NE Ste 401
Salem, OR 97301-3811
Phone (503) 583-4319

Other names 1

  • Elizabeth Delgros Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240828004402 OR Practitioner - Clinical Social Worker 0143766204 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L10746ORMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Rooted Mental Health LLC Clinical CurrentSince Mar 1, 2023 Accepting new patients

Locations

528 Cottage St NE
Ste 401
Salem, OR 97301
Phone (503) 583-4319

Organizations & group practices 1

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": "1327363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1023389970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "528 COTTAGE ST NE STE 401",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973013811",
            "telephone_number": "503-583-4319",
            "fax_number": "503-343-3331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "528 COTTAGE ST NE STE 401",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973013811",
            "telephone_number": "503-583-8537",
            "fax_number": "503-343-3331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELGROS-RYAN",
        "first_name": "ELIZABETH",
        "credential": "MSW,MPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-24",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L10746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "DELGROS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.