Individual provider Active NPI

Timothy Richard Schendel, LCSW

  • Clinical Social Worker
  • Cannon Beach, OR
National Provider Identifier
1154742211
Registry record updated Jan 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
56129 Issued in TX
Practice address
139 W 2ND Ave Ste 4
Cannon Beach, OR 97110-2072
Phone
(503) 440-0046
Fax
(503) 717-6519
NPI assigned
Dec 16, 2013
Last updated
Jan 4, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X L12160 OR
Clinical Social Worker 1041C0700X 82880 CA
Clinical Social Worker 1041C0700X 56129 TX Primary

Addresses

Primary practice location

139 W 2ND Ave Ste 4
Cannon Beach, OR 97110-2072

Mailing address

89121 Pinehurst Rd
Gearhart, OR 97138-7365
Phone (503) 440-0046

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
L12160ORMDClinical Social Worker
56129TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Lutheran Charities Past Accepting new patients
Columbia Lutheran Charities Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1387152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672790400000",
    "number": "1154742211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89121 PINEHURST RD",
            "city": "GEARHART",
            "state": "OR",
            "postal_code": "971387365",
            "telephone_number": "503-440-0046",
            "fax_number": "503-440-0046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 W 2ND AVE STE 4",
            "city": "CANNON BEACH",
            "state": "OR",
            "postal_code": "971102072",
            "telephone_number": "503-440-0046",
            "fax_number": "503-717-6519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHENDEL",
        "first_name": "TIMOTHY",
        "middle_name": "RICHARD",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-12-16",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L12160",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "82880",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "56129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cannon Beach, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2023; 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.