NPIMap

Individual provider Active NPI

Christen Skolnick, LCSW

  • Clinical Social Worker
  • Gresham, OR
National Provider Identifier
1093170342
Registry record updated Dec 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L5312 Issued in OR
Practice address
24988 SE Stark St Ste 140
Mail Code: CMNG
Gresham, OR 97030-8326
Phone
(971) 262-9806
Fax
(971) 262-9501
NPI assigned
Dec 30, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X L5312 OR Primary

Addresses

Primary practice location

24988 SE Stark St Ste 140
Mail Code: CMNG
Gresham, OR 97030-8326

Mailing address

24988 SE Stark St Ste 140
Mail Code: CMNG
Gresham, OR 97030-8326
Phone (971) 262-9806

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
L5312ORMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1451433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451433600000",
    "number": "1093170342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24988 SE STARK ST STE 140",
            "address_2": "MAIL CODE: CMNG",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970308326",
            "telephone_number": "971-262-9806",
            "fax_number": "971-262-9501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24988 SE STARK ST STE 140",
            "address_2": "MAIL CODE: CMNG",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970308326",
            "telephone_number": "971-262-9806",
            "fax_number": "971-262-9501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKOLNICK",
        "first_name": "CHRISTEN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-30",
        "last_updated": "2015-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L5312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2015; 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.