Individual provider Active NPI

Monica De Anne Derosier, QMHP, LCSW

  • Clinical Social Worker
  • Salem, OR
National Provider Identifier
1144500927
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L11161 Issued in OR
Practice address
3085 River Rd N
Salem, OR 97303-6512
Phone
(541) 321-2278
NPI assigned
Aug 24, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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 L11161 OR Primary

Addresses

Primary practice location

3085 River Rd N
Salem, OR 97303-6512

Mailing address

1075 Washington St
Eugene, OR 97401-4606
Phone (541) 321-2278

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
L11161ORMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Arise Counseling Service, LLC. Dba Northlight Counseling Clinical CurrentSince Mar 11, 2025 Accepting new patients

Locations

1075 Washington St
Eugene, OR 97401
Phone (541) 321-2278

3085 River Rd N
Salem, OR 97303
Phone (541) 321-2278

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.

NPI Registry JSON

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

{
    "created_epoch": "1314144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1144500927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1075 WASHINGTON ST",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974014606",
            "telephone_number": "541-321-2278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3085 RIVER RD N",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973036512",
            "telephone_number": "541-321-2278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROSIER",
        "first_name": "MONICA",
        "middle_name": "DE ANNE",
        "name_prefix": "Miss",
        "credential": "QMHP, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-24",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L11161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2025; 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.