Active NPI
Gina Christina Meredith, LCSW
- Clinical Social Worker
- Portland, OR
National Provider Identifier
1376796995
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- L12817
- Practice address
- 9155 SW Barnes Rd Ste 634
Portland, OR 97225-6632 - Phone
- (503) 216-6662
- NPI assigned
- Oct 28, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | L12817 | OR | Primary |
Addresses
Primary practice location
9155 SW Barnes Rd Ste 634
Portland, OR 97225-6632
Mailing address
PO Box 3158
Portland, OR 97208-3158
Phone (503) 215-6494
Other practice location 1
290 Ioof Ave
Gilroy, CA 95020-5204
Phone (408) 846-2138
Other names 1
- Gina Marie Nervina
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L12817 | OR | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1225152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686268800000",
"number": "1376796995",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3158",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972083158",
"telephone_number": "503-215-6494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9155 SW BARNES RD STE 634",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972256632",
"telephone_number": "503-216-6662"
}
],
"practiceLocations": [
{
"address_1": "290 Ioof Ave",
"address_purpose": "LOCATION",
"city": "Gilroy",
"state": "CA",
"postal_code": "950205204",
"country_code": "US",
"telephone_number": "408-846-2138",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MEREDITH",
"first_name": "GINA",
"middle_name": "CHRISTINA",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-10-28",
"last_updated": "2023-06-09",
"certification_date": "2023-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OR",
"license": "L12817",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "GINA",
"last_name": "NERVINA",
"middle_name": "MARIE",
"credential": "ASW",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.