Individual provider Active NPI

Tessa Love, LCSW

  • Clinical Social Worker
  • Corvallis, OR
National Provider Identifier
1053979005
Registry record updated May 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L11423 Issued in OR
Practice address
2150 SW Jefferson Way # 500
Corvallis, OR 97331-8659
Phone
(541) 737-2131
NPI assigned
Jun 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Mental Health Counselor 101YM0800X
Social Worker 104100000X A5718 OR
Clinical Social Worker 1041C0700X L11423 OR Primary

Addresses

Primary practice location

2150 SW Jefferson Way # 500
Corvallis, OR 97331-8659

Mailing address

2150 SW Jefferson Way # 500
Corvallis, OR 97331-8659
Phone (541) 737-2131

Other practice location 1

4455 NE Highway 20
Corvallis, OR 97330-9695
Phone (541) 759-5900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240802001449 OR Practitioner - Clinical Social Worker 4981141363 Reassigns benefits to 1 organization
I20240802002353 WA Practitioner - Clinical Social Worker 4981141363 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A5718ORMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sokyahealth Medical Group PC Counselor CurrentSince Jul 31, 2024 Accepting new patients
Tessa Love LCSW, PLLC Clinical Current Accepting new patients
Shashita Inamdar MD Professional Corporation Past Accepting new patients

Locations

700 NE Multnomah St
Ste 870
Portland, OR 97232
Phone (503) 238-5559

8555 SW Apple Way
Ste 320
Portland, OR 97225
Phone (503) 298-4592

5109 NE 82nd Ave
Ste 215
Vancouver, WA 98662
Phone (832) 840-1604

Networks

  • WA PPO C-SNP
  • devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e

Interoperability endpoints

  • Direct secure messaging: tessa.love.p1@direct.sokya.nextgenshare.com

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": "1559606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714521600000",
    "number": "1053979005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 SW JEFFERSON WAY # 500",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973318659",
            "telephone_number": "541-737-2131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 SW JEFFERSON WAY # 500",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973318659",
            "telephone_number": "541-737-2131"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4455 NE Highway 20",
            "address_purpose": "LOCATION",
            "city": "Corvallis",
            "state": "OR",
            "postal_code": "973309695",
            "country_code": "US",
            "telephone_number": "541-759-5900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOVE",
        "first_name": "TESSA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-04",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OR",
            "license": "A5718",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L11423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

Verify at the official NPI Registry.