Individual provider Active NPI

Marc Francis Chinard, MS, LCSW

  • Clinical Social Worker
  • Gresham, OR
National Provider Identifier
1174679682
Registry record updated Mar 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L3147 Issued in OR
Practice address
4101 NE Division St
Gresham, OR 97030-4617
Phone
(503) 666-6575
Fax
(503) 666-4047
NPI assigned
Jan 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2016

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 L3147 OR Primary

Addresses

Primary practice location

4101 NE Division St
Gresham, OR 97030-4617

Mailing address

4544 SE 48TH Ave
Portland, OR 97206-4144
Phone (503) 407-2326

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200218002148 OR Practitioner - Clinical Social Worker 9739515396 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Recovery Works NW LLCGroup PAC ID 5991049835, 9 clinicians

Practice addresses (Care Compare)

12540 SW Main St
Suite 202
Tigard, OR 97223-6198
Phone (503) 906-9995

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Recovery Works NW LLC CurrentSince Jan 13, 2020 Accepting new patients
Recovery Works NW LLC PastSince Sep 28, 2021 Accepting new patients

Locations

173 NE 102nd Ave
Portland, OR 97220
Phone (503) 252-5100

12612 SE Stark St
Portland, OR 97233
Phone (503) 257-6393

12540 SW Main St
Ste 202
Tigard, OR 97223
Phone (503) 906-9995

Organizations & group practices 2

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": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457308800000",
    "number": "1174679682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4544 SE 48TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972064144",
            "telephone_number": "503-407-2326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 NE DIVISION ST",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970304617",
            "telephone_number": "503-666-6575",
            "fax_number": "503-666-4047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHINARD",
        "first_name": "MARC",
        "middle_name": "FRANCIS",
        "name_prefix": "Mr.",
        "credential": "MS, LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2016-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L3147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

Verify at the official NPI Registry.