Individual provider Active NPI

Angie Lynn Wharfield, LCSW

  • Clinical Social Worker
  • Eugene, OR
National Provider Identifier
1376561548
Registry record updated May 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L3740 Issued in OR
Practice address
10 Shelton McMurphey Blvd
Eugene, OR 97401-4928
Phone
(541) 485-2711
NPI assigned
Jul 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X L3740 OR Primary

Addresses

Primary practice location

10 Shelton McMurphey Blvd
Eugene, OR 97401-4928

Mailing address

10 Shelton McMurphey Blvd
Eugene, OR 97401-4928
Phone (541) 485-2711

Other practice location 1

3377 Riverbend Dr
Springfield, OR 97477-8800
Phone (541) 501-7328

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: No
  • 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
I20230111000951 OR Practitioner - Clinical Social Worker 0345610242 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peacehealth Medical GroupGroup PAC ID 9032023270, 256 clinicians

Practice addresses (Care Compare)

4010 Aerial Way
Eugene, OR 97402-9757
Phone (613) 272-4978

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L3740ORMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth Medical Group CurrentSince Jan 3, 2023 Accepting new patients
Peacehealth Medical Group Mental Health CurrentSince Jan 3, 2023 Accepting new patients
Oslc Developments, Inc. - Clinic PastSince May 16, 2022 Accepting new patients

Locations

4010 Aerial Way
Eugene, OR 97402
Phone (541) 242-8300

Organizations & group practices 3

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652313600000",
    "number": "1376561548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 SHELTON MCMURPHEY BLVD",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974014928",
            "telephone_number": "541-485-2711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 SHELTON MCMURPHEY BLVD",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974014928",
            "telephone_number": "541-485-2711"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3377 Riverbend Dr",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "OR",
            "postal_code": "974778800",
            "country_code": "US",
            "telephone_number": "541-501-7328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHARFIELD",
        "first_name": "ANGIE",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2022-05-12",
        "certification_date": "2022-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "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": "L3740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

Verify at the official NPI Registry.