Individual provider Active NPI

Annie Marie Zander, MSW, CADC III

  • Clinical Social Worker
  • Sandy, OR
National Provider Identifier
1033369459
Registry record updated Mar 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L10216 Issued in OR
Practice address
39084 Proctor Blvd Ste E
Sandy, OR 97055-8064
Phone
(503) 826-8500
Fax
(413) 215-5103
NPI assigned
Sep 22, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 11-03-71 OR
Clinical Social Worker 1041C0700X L10216 OR Primary

Addresses

Primary practice location

39084 Proctor Blvd Ste E
Sandy, OR 97055-8064

Mailing address

39084 Proctor Blvd Ste E
Sandy, OR 97055-8064
Phone (503) 826-8500

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
L10216ORMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sandy Counseling Center Addiction (Substance Use Disorder) CurrentSince Mar 5, 2023 Accepting new patients
Sandy Counseling Center LLP Addiction (Substance Use Disorder) PastSince Feb 26, 2023 Accepting new patients
County of Clackamas Office of County Auditor Past Accepting new patients

Locations

39084 Proctor Blvd
Ste E
Sandy, OR 97055
Phone (503) 317-1077

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": "1222041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1033369459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39084 PROCTOR BLVD STE E",
            "city": "SANDY",
            "state": "OR",
            "postal_code": "970558064",
            "telephone_number": "503-826-8500",
            "fax_number": "413-215-5103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39084 PROCTOR BLVD STE E",
            "city": "SANDY",
            "state": "OR",
            "postal_code": "970558064",
            "telephone_number": "503-826-8500",
            "fax_number": "413-215-5103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZANDER",
        "first_name": "ANNIE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "MSW, CADC III",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-22",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "11-03-71",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L10216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandy, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.