Active NPI
Susan Ann Ponton, LCSW
- Clinical Social Worker
- Portland, OR
National Provider Identifier
1104115849
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- L8443
- Practice address
- 10130 NE Skidmore St
Portland, OR 97220-3570 - Phone
- (503) 257-3787
- Fax
- (971) 279-4634
- NPI assigned
- Apr 4, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | L8443 | OR | Primary |
Addresses
Primary practice location
10130 NE Skidmore St
Portland, OR 97220-3570
Mailing address
1014 Main Street
Vancouver, WA 98660
Phone (360) 695-1014
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| L8443 | Other | OR | LICENSED CLINICAL SOCIAL WORKER |
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
| License | State | Type | Specialty |
|---|---|---|---|
| L8443 | OR | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Solutions, Inc | Past | Accepting new patients |
Interoperability endpoints
- https://api.qualifacts.org/api/fhir/family-solutions/r4/
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Vancouver, WA
- NPI 1831258995
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1301875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572307200000",
"number": "1104115849",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1014 MAIN STREET",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "98660",
"telephone_number": "360-695-1014",
"fax_number": "360-750-1374"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10130 NE SKIDMORE ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972203570",
"telephone_number": "503-257-3787",
"fax_number": "971-279-4634"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PONTON",
"first_name": "SUSAN",
"middle_name": "ANN",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-04-04",
"last_updated": "2019-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OR",
"license": "L8443",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSED CLINICAL SOCIAL WORKER",
"identifier": "L8443",
"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 Oct 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.