Individual provider Active NPI

Lucinda Carrie Dahl, LCSW, LICSW

  • Clinical Social Worker
  • Rhododendron, OR
National Provider Identifier
1306013743
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L2945 Issued in OR
Practice address
65676 E Sandy River LN
Rhododendron, OR 97049-9786
Phone
(503) 545-8839
NPI assigned
May 14, 2008
Last updated
Mar 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LW 60134913 WA
Clinical Social Worker 1041C0700X L2945 OR Primary

Addresses

Primary practice location

65676 E Sandy River LN
Rhododendron, OR 97049-9786

Mailing address

PO Box 295
Brightwood, OR 97011-0295
Phone (503) 545-8839

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
I20251105004509 OR Practitioner - Clinical Social Worker 2860982113 Practice locations: Rhododendron, OR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Rhododendron, OR 97049
Phone (503) 545-8839

PO Box
Suite 295
Brightwood, OR 97011

PO Box
Suite 295
Brightwood, OR 97011-0295

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L2945ORMDClinical Social Worker
LW 60134913WAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1210723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1306013743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 295",
            "city": "BRIGHTWOOD",
            "state": "OR",
            "postal_code": "970110295",
            "telephone_number": "503-545-8839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65676 E SANDY RIVER LN",
            "city": "RHODODENDRON",
            "state": "OR",
            "postal_code": "970499786",
            "telephone_number": "503-545-8839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHL",
        "first_name": "LUCINDA",
        "middle_name": "CARRIE",
        "name_prefix": "Ms.",
        "credential": "LCSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-14",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW 60134913",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L2945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rhododendron, OR

Sources for this page

Verify at the official NPI Registry.