Individual provider Active NPI

Jennifer Vinton-Vanarsdall, LCSW

  • Clinical Social Worker
  • Gresham, OR
National Provider Identifier
1386021707
Registry record updated Jun 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
510 NE Roberts Ave Ste 100
Gresham, OR 97030-7483
Phone
(971) 284-9529
NPI assigned
May 6, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

510 NE Roberts Ave Ste 100
Gresham, OR 97030-7483

Mailing address

510 NE Roberts Ave Ste 100
Gresham, OR 97030-7483
Phone (971) 284-9529

Other names 1

  • Jennifer Vinton-Vanarsdall Other name

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
I20190813000331 OR Practitioner - Clinical Social Worker 4880921964

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Center of Hope Counseling Services LLC CurrentSince Jun 1, 2019 Accepting new patients

Locations

510 NE Roberts Ave
Ste 100
Gresham, OR 97030
Phone (503) 665-5158

Organizations & group practices 1

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": "1430870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561507200000",
    "number": "1386021707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 NE ROBERTS AVE STE 100",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970307483",
            "telephone_number": "971-284-9529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 NE ROBERTS AVE STE 100",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970307483",
            "telephone_number": "971-284-9529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINTON-VANARSDALL",
        "first_name": "JENNIFER",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-06",
        "last_updated": "2019-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "VINTON-VANARSDALL",
            "credential": "MSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Gresham, OR

Sources for this page

Verify at the official NPI Registry.