Andrea Mize LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

7328 Issued in OR

Legal business name

ANDREA MIZE LLC

Practice address

10175 SW Barbur Blvd Ste 300BG
Portland, OR 97219-5909

Phone

(503) 957-5947

Fax

(503) 206-0926

NPI assigned

Apr 20, 2017

Organization subpart

No

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

Authorized official

Name

Andrea L Mize, L.C.S.W.NPI 1043598659

Title

Owner

Phone

(503) 957-5947

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Andrea Lynn Mize, L.C.S.W.

  • Clinical Social Worker
  • Portland, OR
  • NPI 1043598659

  Clinical, OR

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1492646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546387200000",
    "number": "1124553797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 MONROE PKWY",
            "address_2": "STE P 242",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970351486",
            "telephone_number": "503-957-5947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10175 SW BARBUR BLVD STE 300BG",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972195909",
            "telephone_number": "503-957-5947",
            "fax_number": "503-206-0926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDREA MIZE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-20",
        "last_updated": "2019-01-02",
        "status": "A",
        "authorized_official_last_name": "MIZE",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-957-5947",
        "authorized_official_credential": "L.C.S.W."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "7328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Andrade, LMT
• Benjamin Andraschko
• Derek Justin Andre, N.D.
• Andrea M Fraser DDS LLC
• Andrea Marie Nutritional Counseling
• Laura K Andreas, RD
• Mina T Andreas, L.M.T.
• Christa R Andreasen, RN
• Molly Andreason, MD
• Juleeanna Andreoni, LD RD CDE

• All providers in Portland, OR
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.