Active NPI
Rose Sweetwater, LCSW
- Clinical Social Worker
- Corvallis, OR
National Provider Identifier
1376974873
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- L5169
- Practice address
- 815 NW 9TH St #110
Corvallis, OR 97330 - Phone
- (541) 768-6770
- Fax
- (541) 768-9771
- NPI assigned
- Dec 9, 2013
- 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 | L5169 | OR | Primary |
Addresses
Primary practice location
815 NW 9TH St #110
Corvallis, OR 97330
Mailing address
815 NW 9TH St #110
Corvallis, OR 97330
Phone (541) 768-6770
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 |
|---|---|---|---|
| L5169 | OR | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1386547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436313600000",
"number": "1376974873",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "815 NW 9TH ST #110",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "97330",
"telephone_number": "541-768-6770",
"fax_number": "541-768-9771"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "815 NW 9TH ST #110",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "97330",
"telephone_number": "541-768-6770",
"fax_number": "541-768-9771"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SWEETWATER",
"first_name": "ROSE",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-12-09",
"last_updated": "2015-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OR",
"license": "L5169",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corvallis, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.