Individual provider Active NPI

Samantha C Cunningham, LCSW

  • Clinical Social Worker
  • Portland, OR
National Provider Identifier
1386195139
Registry record updated Feb 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L7991 Issued in OR
Practice address
10920 SW Barbur Blvd
Portland, OR 97219-8600
Phone
(541) 687-1110
NPI assigned
Oct 17, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LH60630652 WA
Clinical Social Worker 1041C0700X L7991 OR Primary
Clinical Social Worker 1041C0700X LW61371985 WA

Addresses

Primary practice location

10920 SW Barbur Blvd
Portland, OR 97219-8600

Mailing address

10920 SW Barbur Blvd
Portland, OR 97219-8600
Phone (541) 687-1110

Other identifiers 1

IdentifierTypeStateIssuer
500717085MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, VT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190509001641 OR Practitioner - Clinical Social Worker 6608119805 Reassigns benefits to 2 organizations
I20230713001669 VT Practitioner - Clinical Social Worker 6608119805 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LH60630652WAMDMental Health Counselor
L7991ORMDClinical Social Worker
089.0135350VTMDClinical Social Worker
LW61371985WAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lutheran Community Services Northwest CurrentSince Jan 11, 2025 Accepting new patients
Valera Medical, P.a. Mental Health CurrentSince Jun 28, 2023 Accepting new patients
Lutheran Community Services Northwest CurrentSince Jan 11, 2025 Accepting new patients

Locations

134 N 4th St
Brooklyn, NY 11249

605 SE Cesar E Chavez Blvd
Portland, OR 97214
Phone (503) 731-9539

1 Lawson Ln
Ste 200D
Burlington, VT 05401
Phone (802) 236-6742

Organizations & group practices 4

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": "1476662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771286400000",
    "number": "1386195139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10920 SW BARBUR BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972198600",
            "telephone_number": "541-687-1110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10920 SW BARBUR BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972198600",
            "telephone_number": "541-687-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "SAMANTHA",
        "middle_name": "C",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-17",
        "last_updated": "2026-02-17",
        "certification_date": "2026-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60630652",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L7991",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61371985",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500717085",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.