Eileen Bradley Summit, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1995 Issued in OR

Practice address

637 N Farragut St
Portland, OR 97217-1473

Phone

(503) 358-5130

NPI assigned

Jul 8, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1594166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594166400000",
    "number": "1124646955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "637 N FARRAGUT ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972171473",
            "telephone_number": "503-358-5130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "637 N FARRAGUT ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972171473",
            "telephone_number": "503-358-5130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMMIT",
        "first_name": "EILEEN",
        "middle_name": "BRADLEY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-08",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "1995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Summit Oregon LLC
• Summit Psychiatry & Counseling LLC
• Summit Radiology Inc
• Summit Recovery Center
• Summit Support Group LLC
• Mark Wallace Honeywell Summit, LCSW
• Hannah Sumner, MASTERS IN SPEECH
• Steven Glenn Sumner, M.A.
• William Charles Sumner, MD
• Delaney Rose Sump, MS, RD, CPT, NBCHWC

• Clinical Social Worker in Portland, OR
• Providers in Portland, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2020; 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.

Verify at the official NPI Registry.