Individual provider Active NPI

David James Casey, LCSW

  • Clinical Social Worker
  • Salem, OR
National Provider Identifier
1396080933
Registry record updated Apr 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L8114 Issued in OR
Practice address
2586 12TH PL SE
Salem, OR 97302-2536
Phone
(503) 371-4160
Fax
(503) 375-9727
NPI assigned
Dec 9, 2012
Last updated
Apr 18, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X L8114 OR Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 12-09-07 OR

Addresses

Primary practice location

2586 12TH PL SE
Salem, OR 97302-2536

Mailing address

51377 SW Old Portland Rd
Scappoose, OR 97056-4023
Phone (503) 418-4222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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 1

Enrollment IDStateProvider typePAC IDDetails
I20190611000499 OR Practitioner - Clinical Social Worker 1153654942 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

51377 SW Old Portland Rd
Scappoose, OR 97056-4023
Phone (503) 418-4222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L8114ORMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Oregon Health & Science University CurrentSince Apr 14, 2019 Accepting new patients
Oregon Health & Science University CurrentSince Apr 14, 2019 Accepting new patients
Creekside Counseling, Inc Past Accepting new patients
Creekside Counseling Inc Addiction (Substance Use Disorder) Past Accepting new patients

Locations

51377 SW Old Portland Rd
Scappoose, OR 97056
Phone (503) 418-4222

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1355011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555545600000",
    "number": "1396080933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51377 SW OLD PORTLAND RD",
            "city": "SCAPPOOSE",
            "state": "OR",
            "postal_code": "970564023",
            "telephone_number": "503-418-4222",
            "fax_number": "503-418-4223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2586 12TH PL SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973022536",
            "telephone_number": "503-371-4160",
            "fax_number": "503-375-9727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASEY",
        "first_name": "DAVID",
        "middle_name": "JAMES",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-09",
        "last_updated": "2019-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L8114",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "12-09-07",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.