Emma Susann Anderson, LCSW
Individual provider Active NPI Clinical Social Worker · Bend, OR
NPI 1023459591 · NPPES record last updated Jun 7, 2022
Key facts
- NPI
- 1023459591
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- L10995 (OR)
- Practice address
- 2577 NE Courtney Dr
Bend, OR 97701-7752 - Phone
- (541) 322-7500
- Fax
- (541) 322-7565
- NPI assigned
- Jul 12, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Deschutes County Oregon
Practice addresses (Care Compare)
2577 NE Courtney Dr
Bend, OR 97701-7638
Phone (541) 322-7400
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220629002040 | OR | Practitioner - Clinical Social Worker | 3072993625 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Deschutes County Oregon | Current | Accepting new patients | |
| Deschutes County Oregon | Current |
Accepting new patients | |
| Deschutes County Oregon | Current |
Accepting new patients |
Locations
2577 NE Courtney Dr
Bend, OR 97701
Phone (541) 322-7400
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Clinical Social Worker | 1041C0700X | L10995 | OR | Yes |
Addresses
Primary practice location
2577 NE Courtney Dr
Bend, OR 97701-7752
Mailing address
2577 NE Courtney Dr
Bend, OR 97701-7752
Phone (541) 322-7500
Other providers in Bend, OR
- Amy Michelle Anderson
- Bryon Anderson
- Carol J Anderson
- Daniel Anderson
- Donald Robert Anderson
- Erica Anderson
- Erika Anderson
- Fe Louisa Anderson
- Jenny Rand Anderson
- Jordan Anderson
All providers in Bend, OR · Clinical Social Worker in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 7, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.