Active NPI
Michelle L Krummenacker, LCSW
- Clinical Social Worker
- Clackamas, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- L3197
- Practice address
- 9123 SE Saint Helens St Ste 100F
Clackamas, OR 97015-6800 - Phone
- (503) 740-1971
- Fax
- (503) 771-2436
- NPI assigned
- Jul 31, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 98-07-34 | OR | |
| Clinical Social Worker | 1041C0700X | L3197 | OR | Primary |
Addresses
Primary practice location
9123 SE Saint Helens St Ste 100F
Clackamas, OR 97015-6800
Mailing address
10117 SE Sunnyside Rd
Suite F, Box 1217
Clackamas, OR 97015-7708
Phone (503) 740-1971
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1217 NE Burnside Rd
Suite 701
Gresham, OR 97030-5770
Phone (503) 740-1971
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L3197 | OR | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chaise Group, LLC | Addiction (Substance Use Disorder) | Current | Accepting new patients |
Locations
11211 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 513-7425
9123 SE Saint Helens St
Ste 100F
Clackamas, OR 97015
Phone (503) 740-6449
10117 SE Sunnyside Rd
#F1217
Clackamas, OR 97015
Phone 50374019711010
10117 SE Sunnyside Rd
Ste F1217
Clackamas, OR 97015
9123 SE Saint Helens St
Ste 100C
Clackamas, OR 97015
1217 NE Burnside Rd
Ste 704
Gresham, OR 97030
Phone (503) 661-2577
1217 NE Burnside Rd
Ste 701
Gresham, OR 97030
Phone (503) 407-1239
10117 SE Sunnyside Rd
Ste F
Happy Valley, OR 97015
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.
-
- Multi-Specialty Clinic/Center
- Clackamas, OR
- NPI 1073720017
Addiction (Substance Use Disorder)
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750723200000",
"number": "1124033618",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10117 SE SUNNYSIDE RD",
"address_2": "SUITE F, BOX 1217",
"city": "CLACKAMAS",
"state": "OR",
"postal_code": "970157708",
"telephone_number": "503-740-1971",
"fax_number": "503-771-2436"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9123 SE SAINT HELENS ST STE 100F",
"city": "CLACKAMAS",
"state": "OR",
"postal_code": "970156800",
"telephone_number": "503-740-1971",
"fax_number": "503-771-2436"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRUMMENACKER",
"first_name": "MICHELLE",
"middle_name": "L",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-31",
"last_updated": "2025-06-24",
"certification_date": "2025-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OR",
"license": "98-07-34",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OR",
"license": "L3197",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Clackamas, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.