NPIMap

Organization Active NPI

Mary Anne Stowell LCSW, PC

  • Clinical Social Worker
  • Portland, OR
National Provider Identifier
1326159773
Registry record updated Oct 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L2934 Issued in OR
Legal business name
MARY ANNE STOWELL LCSW, PC
Practice address
4511 SE Hawthorne Blvd
Suite 114
Portland, OR 97215-3170
Phone
(503) 232-6868
Fax
(503) 253-1285
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2010

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

Authorized official

Name
Mary Anne Stowell, LCSWNPI 1124293113
Title
Ceo
Phone
(503) 408-1759

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X L2934 OR Primary

Addresses

Primary practice location

4511 SE Hawthorne Blvd
Suite 114
Portland, OR 97215-3170

Mailing address

4511 SE Hawthorne Blvd
Suite 114
Portland, OR 97215-3170
Phone (503) 232-6868

Other identifiers 6

IdentifierTypeStateIssuer
0001095800OtherMHN
7299505OtherAETNA
825404000OtherORREGENCE BLUE CROSS
182996MedicaidOR
330833000001OtherPROVIDENCE HEALTH PLAN
475273OtherHTH WORLD WIDE

National Provider Directory

National Provider Directory

Locations

4511 SE Hawthorne Blvd
Ste 114
Portland, OR 97215
Phone (503) 232-6868

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286755200000",
    "number": "1326159773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4511 SE HAWTHORNE BLVD",
            "address_2": "SUITE 114",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972153170",
            "telephone_number": "503-232-6868",
            "fax_number": "503-253-1285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4511 SE HAWTHORNE BLVD",
            "address_2": "SUITE 114",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972153170",
            "telephone_number": "503-232-6868",
            "fax_number": "503-253-1285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY ANNE STOWELL LCSW, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2010-10-11",
        "status": "A",
        "authorized_official_last_name": "STOWELL",
        "authorized_official_first_name": "MARY ANNE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "503-408-1759",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L2934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN",
            "identifier": "0001095800",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7299505",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE CROSS",
            "identifier": "825404000",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "182996",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDENCE HEALTH PLAN",
            "identifier": "330833000001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HTH WORLD WIDE",
            "identifier": "475273",
            "state": null
        }
    ],
    "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 Oct 11, 2010; 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.