Individual provider Active NPI

Karen Faye McVicker, MSW, LICSW, LCSW

  • Clinical Social Worker
  • Portland, OR
National Provider Identifier
1316218746
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L8067 Issued in OR
Practice address
3415 SE Powell Blvd
Portland, OR 97202-3371
Phone
(503) 234-9591
NPI assigned
Jan 17, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 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 WA
Clinical Social Worker 1041C0700X L8067 OR Primary

Addresses

Primary practice location

3415 SE Powell Blvd
Portland, OR 97202-3371

Mailing address

1700 NW Civic Dr Ste 310
Gresham, OR 97030-3774
Phone (503) 666-8832

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200416001693 WA Practitioner - Clinical Social Worker 9133552029 Reassigns benefits to 1 organization
I20230303002230 OR Practitioner - Clinical Social Worker 9133552029 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2222 E Powell Blvd
Gresham, OR 97080-1365
Phone (503) 669-4300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L8067ORMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Willapa Counseling Center CurrentSince Mar 9, 2020 Accepting new patients
Western Psychological and Counseling Services LLC CurrentSince Nov 2, 2022 Accepting new patients
Western Psychological and Counseling Services LLC Clinical CurrentSince Nov 2, 2022 Accepting new patients

Locations

880 82nd Dr
Gladstone, OR 97027
Phone (503) 626-9494

1700 NW Civic Dr
Ste 310
Gresham, OR 97030
Phone (503) 666-8832

2222 E Powell Blvd
Gresham, OR 97080
Phone (503) 669-4300

2204 Pacific Ave N
Long Beach, WA 98631
Phone (360) 642-3787

Organizations & group practices 3

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": "1326758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1316218746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 NW CIVIC DR STE 310",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303774",
            "telephone_number": "503-666-8832",
            "fax_number": "503-669-8641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 SE POWELL BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972023371",
            "telephone_number": "503-234-9591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCVICKER",
        "first_name": "KAREN",
        "middle_name": "FAYE",
        "name_prefix": "Miss",
        "credential": "MSW, LICSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-17",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L8067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.