Individual provider Active NPI

Hallie Havican, LCSW

  • Clinical Social Worker
  • Portland, OR
National Provider Identifier
1124459771
Registry record updated Aug 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ASW-68709 Issued in CA
Practice address
1110 SE Alder St # 310
Portland, OR 97214-2400
Phone
(503) 847-9950
NPI assigned
Dec 9, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2019

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 ASW-68709 CA Primary

Addresses

Primary practice location

1110 SE Alder St # 310
Portland, OR 97214-2400

Mailing address

PO Box 86953
Portland, OR 97286-0953
Phone (503) 847-9950

Other practice location 1

3870 Rosin Ct Ste 130
Sacramento, CA 95834-1647
Phone (916) 363-1553

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
ASW-68709CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1386547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564876800000",
    "number": "1124459771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 86953",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972860953",
            "telephone_number": "503-847-9950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 SE ALDER ST # 310",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972142400",
            "telephone_number": "503-847-9950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3870 Rosin Ct Ste 130",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958341647",
            "country_code": "US",
            "telephone_number": "916-363-1553",
            "fax_number": "916-363-1638",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAVICAN",
        "first_name": "HALLIE",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-09",
        "last_updated": "2019-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW-68709",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 4, 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.

Verify at the official NPI Registry.