Active NPI
Christina J Mullin, LCSW
- Clinical Social Worker
- Portland, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 10808
- Practice address
- 1130 SW Morrison St Ste 328
Portland, OR 97205-2214 - Phone
- (503) 479-5636
- Fax
- (855) 918-3577
- NPI assigned
- Sep 8, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 10808 | OR | Primary |
Addresses
Primary practice location
1130 SW Morrison St Ste 328
Portland, OR 97205-2214
Mailing address
4207 SE Woodstock Blvd # 138
Portland, OR 97206-6267
Phone (503) 479-5636
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250211003287 | OR | Practitioner - Clinical Social Worker | 1456881093 | Practice locations: Portland, OR |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
1130 SW Morrison St
Suite 328
Portland, OR 97205-2214
Phone (503) 479-5636
4207 SE Woodstock Blvd
Suite 138
Portland, OR 97206-6267
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10808 | OR | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aligned Intent LLC | Clinical | Current | Accepting new patients |
Locations
4207 SE Woodstock Blvd
Portland, OR 97206
Phone (503) 312-6005
1130 SW Morrison St
Ste 328
Portland, OR 97205
Phone (503) 479-5636
Organizations & group practices 1
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.
-
- Clinical Social Worker
- Portland, OR
- NPI 1386329829
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1662595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689638400000",
"number": "1265153126",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4207 SE WOODSTOCK BLVD # 138",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972066267",
"telephone_number": "503-479-5636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1130 SW MORRISON ST STE 328",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972052214",
"telephone_number": "503-479-5636",
"fax_number": "855-918-3577"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULLIN",
"first_name": "CHRISTINA",
"middle_name": "J",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-08",
"last_updated": "2023-07-18",
"certification_date": "2023-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OR",
"license": "10808",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.