Alice Marie Sampson, CSWA/CADC II

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

A3588 Issued in OR

Practice address

1631 SW Columbia St
Portland, OR 97201-6025

Phone

(503) 231-2641

Fax

(503) 231-1654

NPI assigned

Nov 16, 2016

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1479254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479254400000",
    "number": "1235671637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1776 SW MADISON ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972051715",
            "telephone_number": "971-386-2278",
            "fax_number": "503-224-4494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1631 SW COLUMBIA ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972016025",
            "telephone_number": "503-231-2641",
            "fax_number": "503-231-1654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMPSON",
        "first_name": "ALICE",
        "middle_name": "MARIE",
        "credential": "CSWA/CADC II",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-16",
        "last_updated": "2016-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "93-02-02",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "A3588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Samols, MS
• Sandra A Sampeer, CRNA
• Erika V Sample, PSYD
• Joshua Thomas Sample
• Carissa Walker Samples, CSWA
• Ellen Sampson
• Jone Elizabeth Sampson, MD
• Robert Allan Sampson, DPM
• Robin Sampson, LMT
• Sehra Dove Sampson, MD

• 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 Nov 16, 2016; 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.