Jennifer Marie Dodd, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L7965 Issued in OR

Practice address

1722 NW Raleigh St SPC 412
Portland, OR 97209

Phone

(240) 483-9647

NPI assigned

Oct 11, 2018

Sex

Female

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Embodied Life Therapy Center LLC

  • Clinical Social Worker
  • Portland, OR
  • NPI 1265039564
  NPD Authorized official

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

{
    "created_epoch": "1539216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585008000000",
    "number": "1154896546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6906 N RICHARDS ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972036138",
            "telephone_number": "971-266-1081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1722 NW RALEIGH ST SPC 412",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97209",
            "telephone_number": "240-483-9647"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8170 Beverly Blvd",
            "address_2": "200",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "90048",
            "country_code": "US",
            "telephone_number": "310-720-8200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DODD",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-11",
        "last_updated": "2020-03-24",
        "certification_date": "2020-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L7965",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L7695",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Travis Dockter, M.S.
• Corina Doctrine, ND
• Claire E.M. Dodd, PSYD
• Clarice Dodd
• Hannah S Dodd, PA-C
• Joshua Daniel Dodd
• Lana Dodd
• Jacob Rock Doddridge, MD
• Charles Richey Dodds, M.D.
• Winona Rose Andrus Dodds

• 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 Mar 24, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.