Laila Josephine Ayyoub, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L4558 Issued in OR

Practice address

3085 NW Deer Run St
Corvallis, OR 97330-3104

Phone

(541) 760-0777

NPI assigned

Jun 13, 2007

Last updated

May 11, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Laila Josephine Ayyoub Cusick Former name

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

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kaiser Foundation Health Plan of the Northwest

  • General Practice Physician
  • Portland, OR
  • NPI 1184786527
  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Northwest

  • General Practice Physician
  • Portland, OR
  • NPI 1306192455
  NPD
• Kaiser Foundation Health Plan of the Northwest

  • Clinic/Center
  • Hillsboro, OR
  • NPI 1942718622
  NPD

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431302400000",
    "number": "1083818124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3085 NW DEER RUN ST",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303104",
            "telephone_number": "541-760-0777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3085 NW DEER RUN ST",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303104",
            "telephone_number": "541-760-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYYOUB",
        "first_name": "LAILA",
        "middle_name": "JOSEPHINE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-13",
        "last_updated": "2015-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L4558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAILA",
            "last_name": "CUSICK",
            "middle_name": "JOSEPHINE AYYOUB",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Awakened Heart LLC
• Stephanie Anne Axman, M.D.
• Myo Sabai Aye, M.D.
• Leela Ayres
• Nesreen Aysheh
• Emily Etheram Azadnia
• Gulrez Shah Azhar, MD
• Robert W Babbel, MD
• Diane Bach, HEARING AID SPECIALI
• Micki Bachand, LPC

• Clinical Social Worker in Corvallis, OR
• Providers in Corvallis, 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 May 11, 2015; 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.