Jacqueline Sharib, LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

1333 NW 9TH St
Prineville, OR 97754-1482

Phone

(541) 447-2631

NPI assigned

Apr 30, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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

Specialty

Clinical Social Worker

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rimrock Trails Treatment ServicesGroup PAC ID 5799107629, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rimrock Trails Treatment Services

  dba Rimrock Trails ATS

  • Children's Substance Abuse Rehabilitation Facility
  • Prineville, OR
  • NPI 1194873406
  Medicare reassignment Care Compare group NPD
• Lutheran Community Services Northwest

  dba Lcsnw

  • Community/Behavioral Health Agency
  • McMinnville, OR
  • NPI 1255542106
  NPD (past)

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

{
    "created_epoch": "1398816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1356751283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333 NW 9TH ST",
            "city": "PRINEVILLE",
            "state": "OR",
            "postal_code": "977541482",
            "telephone_number": "541-447-2631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 NW 9TH ST",
            "city": "PRINEVILLE",
            "state": "OR",
            "postal_code": "977541482",
            "telephone_number": "541-447-2631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARIB",
        "first_name": "JACQUELINE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-30",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "283234",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Geoffrey Michael Saunders, PHARMD
• Charissa Schmidt
• Adriaa L Schmitt, LMT
• Shana L Schmitz, MA, LPC
• Nicole Seal
• Hugh Thomas Shepard, QMHA
• Patricia Short, LPC
• Ryan Short, DPT
• Kayle Ryn Shrauger
• Caitlin Silveria

• Mental Health Counselor in Prineville, OR
• Providers in Prineville, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.