NPIMap

Organization Active NPI

Michael P Beaver LCSW Inc

  • Clinical Social Worker
  • Salem, OR
National Provider Identifier
1194867382
Registry record updated Nov 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
717 Issued in OR
Legal business name
MICHAEL P BEAVER LCSW INC
Practice address
2367 State St Ste 100
Salem, OR 97301-4541
Phone
(503) 587-0623
Fax
(503) 391-7422
NPI assigned
Feb 13, 2007
Last updated
Nov 5, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2009

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

Authorized official

Name
Michael P Beaver, LCSWNPI 1962464735
Title
Owner
Phone
(503) 540-3442

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 717 OR Primary

Addresses

Primary practice location

2367 State St Ste 100
Salem, OR 97301-4541

Mailing address

2367 State St Ste 100
Salem, OR 97301-4541
Phone (503) 540-3442

National Provider Directory

National Provider Directory

Locations

2367 State St
Salem, OR 97301
Phone (503) 540-3442

2367 State St
Ste 100
Salem, OR 97301
Phone (503) 568-2854

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257379200000",
    "number": "1194867382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2367 STATE ST STE 100",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973014541",
            "telephone_number": "503-540-3442",
            "fax_number": "503-540-4097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2367 STATE ST STE 100",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973014541",
            "telephone_number": "503-587-0623",
            "fax_number": "503-391-7422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL P BEAVER LCSW INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2009-11-05",
        "status": "A",
        "authorized_official_last_name": "BEAVER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-540-3442",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "717",
            "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 Nov 5, 2009; 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.