Annamarie H Mattox, BSW, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L10905 Issued in OR

Practice address

351 S Main St # 23
Jefferson, OR 97352-9401

Phone

(541) 905-8173

NPI assigned

Mar 25, 2015

Last updated

May 13, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sondermind PAGroup PAC ID 3577099621, 78 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.

• Sondermind, P.a.

  • Clinical Social Worker
  • Wichita, KS
  • NPI 1710647581

  Mental Health, OR

  Medicare reassignment Care Compare group NPD
• Options Counseling Services of Oregon

  dba Options Counseling and Family Services

  • Mental Health Counselor
  • Eugene, OR
  • NPI 1548275217
  Medicare reassignment NPD
• Reclaim Life, LLC

  • Clinical Social Worker
  • Albany, OR
  • NPI 1043788896
  Medicare reassignment NPD
• The Shangri-la Corporation

  dba Shangri-La Corporation

  • Community/Behavioral Health Agency
  • Eugene, OR
  • NPI 1053858993
  NPD (past)

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

{
    "created_epoch": "1427241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1366836579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 TERRITORIAL ST",
            "city": "HARRISBURG",
            "state": "OR",
            "postal_code": "974469554",
            "telephone_number": "971-301-2189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 S MAIN ST # 23",
            "city": "JEFFERSON",
            "state": "OR",
            "postal_code": "973529401",
            "telephone_number": "541-905-8173"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4080 Reed Rd SE Ste 150",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "973021335",
            "country_code": "US",
            "telephone_number": "503-581-1732",
            "fax_number": "503-581-5638",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1515 Liberty St SE",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "973024345",
            "country_code": "US",
            "telephone_number": "503-951-6280 x3203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "425 2nd Ave SW Ste 102",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "OR",
            "postal_code": "973212483",
            "country_code": "US",
            "telephone_number": "541-286-3209",
            "fax_number": "541-704-0040",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "398 High St",
            "address_purpose": "LOCATION",
            "city": "Eugene",
            "state": "OR",
            "postal_code": "974012310",
            "country_code": "US",
            "telephone_number": "541-344-1121",
            "fax_number": "541-344-4780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATTOX",
        "first_name": "ANNAMARIE",
        "middle_name": "H",
        "credential": "BSW, MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-25",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L10905",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500705747",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathleen Marr Chitwood, RDH,LAP
• Julie Ann Gilbert, MD
• Madelyn Marie Hammons, R.D.H.
• Patrick Lynn Hart, D.C.
• Jefferson Rural Fire Protection Dist
• Recovery Road Inc (Pacific Ridge Residential Alcohol and Drug Treatment Center)
• David Eugene Sanchez Jr., REV., CRM,
• Ann Schlomer Lehoullier, D.V.M.
• Shangri-la Corporation
• Kurstee Simmons

• Clinical Social Worker in Jefferson, OR
• Providers in Jefferson, 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 May 13, 2025; 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.