Individual provider Active NPI

Rasheeda Nimot Crowder, LCSW

  • Social Worker
  • Salem, VA
National Provider Identifier
1346406550
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
L15228 Issued in OR
Practice address
1970 Roanoke Blvd
Salem, VA 24153-6404
Phone
(540) 982-2463
Fax
(540) 224-1932
NPI assigned
Aug 6, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 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 0904007951 VA
Social Worker 104100000X L15228 OR Primary

Addresses

Primary practice location

1970 Roanoke Blvd
Salem, VA 24153-6404

Mailing address

PO Box 3777
Portland, OR 97208-3777

Other practice location 1

2222 NW Lovejoy St Ste 315
Portland, OR 97210
Phone (503) 413-8018

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
I20241030000963 OR Practitioner - Clinical Social Worker 7810234820 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Clinics LLCGroup PAC ID 0244144004, 714 clinicians

Practice addresses (Care Compare)

2222 NW Lovejoy St
Suite 315
Portland, OR 97210-5101
Phone (503) 413-8018

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904007951VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Clinics LLC CurrentSince Oct 22, 2024 Accepting new patients
Legacy Clinics LLC CurrentSince Oct 22, 2024 Accepting new patients

Locations

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

2222 NW Lovejoy St
Ste 315
Portland, OR 97210
Phone (503) 226-6321

Organizations & group practices 2

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": "1217980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1346406550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3777",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 ROANOKE BLVD",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241536404",
            "telephone_number": "540-982-2463",
            "fax_number": "540-224-1932"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2222 NW Lovejoy St Ste 315",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "97210",
            "country_code": "US",
            "telephone_number": "503-413-8018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CROWDER",
        "first_name": "RASHEEDA",
        "middle_name": "NIMOT",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-06",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904007951",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OR",
            "license": "L15228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, VA

Sources for this page

Verify at the official NPI Registry.