Active NPI
Kaeli Harwood, LCSW
- Clinical Social Worker
- Portland, OR
National Provider Identifier
1043857568
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- A12270
- Practice address
- 33 NW Broadway
Portland, OR 97209-3580 - Phone
- (503) 228-7134
- NPI assigned
- Dec 3, 2019
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | A12270 | ||
| Adult Companion | 372600000X | |||
| Clinical Social Worker | 1041C0700X | A12270 | OR | Primary |
Addresses
Primary practice location
33 NW Broadway
Portland, OR 97209-3580
Mailing address
PO Box 8459
Portland, OR 97207-8459
Other practice location 1
3704 NE 60th St
Vancouver, WA 98661-1740
Phone (541) 394-5833
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12032019540529 | Medicaid | OR |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240328003523 | OR | Order and Referring Only - Clinical Social Worker | 9739527524 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A12270 | OR | MD | Clinical Social Worker |
Networks
- WA PPO C-SNP
- devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1575331200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744588800000",
"number": "1043857568",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8459",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972078459"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "33 NW BROADWAY",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972093580",
"telephone_number": "503-228-7134"
}
],
"practiceLocations": [
{
"address_1": "3704 NE 60th St",
"address_purpose": "LOCATION",
"city": "Vancouver",
"state": "WA",
"postal_code": "986611740",
"country_code": "US",
"telephone_number": "541-394-5833",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HARWOOD",
"first_name": "KAELI",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-12-03",
"last_updated": "2025-04-14",
"certification_date": "2025-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": "A12270",
"primary": false
},
{
"code": "372600000X",
"taxonomy_group": "",
"desc": "Adult Companion",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OR",
"license": "A12270",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "12032019540529",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.