Skyler Whitley, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L11712 Issued in OR

Practice address

937 NE 76TH Ave
Portland, OR 97213-6258

Phone

(541) 515-8887

NPI assigned

Sep 4, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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

Mental Health Counselor

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

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": "1693785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1124804331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "937 NE 76TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972136258",
            "telephone_number": "971-319-2393",
            "fax_number": "971-351-6936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "937 NE 76TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972136258",
            "telephone_number": "541-515-8887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITLEY",
        "first_name": "SKYLER",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-04",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OR",
            "license": "A12865",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L11712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Whiting, M.D.
• Miyka Whiting, M.S., CCC-SLP
• Britta Callesen Whitley, RN
• Jackie Whitley
• Lynn Carman Whitley, DMD
• Evelyn Patricia Whitlock, MD, MPH
• Sule L Whitlock
• Christina Whitlow, IBCLC
• David Linwood Whitlow III, DC
• Anastacia M. Whitman, DMD

• 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 Dec 5, 2024; 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.