Elena Wadsworth

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L11907 Issued in OR

Practice address

3050 SE Division St Ste 215
Portland, OR 97202-1997

Phone

(503) 622-8964

NPI assigned

May 27, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Larsen Sanchez Psychology, LLC

  • Clinical Psychologist
  • Portland, OR
  • NPI 1588041388
  Medicare reassignment
• Portland Neurofeedback, LLC

  • Mental Health Counselor
  • Portland, OR
  • NPI 1558875476
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1653609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1083353106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 SE 55TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972153345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 SE DIVISION ST STE 215",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972021997",
            "telephone_number": "503-622-8964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADSWORTH",
        "first_name": "ELENA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-27",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L11907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Marie Wadford, FNP
• Brian D Wadley, M.D.
• Jenny Lynn Wadman, PT
• Elizabeth Wadnizak, LMT
• Keenan Wadnizak
• John G Wadsworth, LCSW
• Elizabeth Waechter Smith, CADC I
• Patricia Wafer
• Amy Linn Wagamon, PTA
• Shelly Wagar, LAC

• Clinical Social Worker in Portland, OR
• Providers in Portland, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; 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.

Verify at the official NPI Registry.