Jacob Reese, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L8065 Issued in OR

Practice address

11211 SE 82ND Ave Ste 0
Portland, OR 97086-7641

Phone

(503) 722-6200

Fax

(503) 722-6545

NPI assigned

Oct 26, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Clackamas County

  • Federally Qualified Health Center (FQHC)
  • Oregon City, OR
  • NPI 1841443587
  Medicare reassignment NPD
• County of Clackamas Office of County Auditor

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Milwaukie, OR
  • NPI 1245269315
  NPD

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

{
    "created_epoch": "1445817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564012800000",
    "number": "1346612652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8459",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972078459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11211 SE 82ND AVE STE 0",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "970867641",
            "telephone_number": "503-722-6200",
            "fax_number": "503-722-6545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REESE",
        "first_name": "JACOB",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-26",
        "last_updated": "2019-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L8065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500710078",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marjorie J Reedy
• Christine Jennifer Reeh, L.C.S.W.
• Michelle Rees
• Robert Rees, BA, QMHP
• David Reese
• Jill R. Reese, LCSW
• Joshua M Reese, MD
• Katherine Rose Reese, PHARMD
• Molly Reese
• Rachel Reese

• Clinical Social Worker in Portland, OR
• Providers in Portland, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.