Active NPI
Sophia Parris, LCSW
- Clinical Social Worker
- Bend, OR
National Provider Identifier
1396142832
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- L10555
- Practice address
- 1011 SW Emkay Dr
Bend, OR 97702-3162 - Phone
- (541) 323-3477
- NPI assigned
- Nov 27, 2014
- 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 | L10555 | OR | Primary |
Addresses
Primary practice location
1011 SW Emkay Dr
Bend, OR 97702-3162
Mailing address
1011 SW Emkay Dr
Bend, OR 97702-3162
Phone (541) 323-3477
Other names 1
- Sophia Visada
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jun 27, 2024 through Jun 27, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L10555 | OR | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1417046400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630368000000",
"number": "1396142832",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1011 SW EMKAY DR",
"city": "BEND",
"state": "OR",
"postal_code": "977023162",
"telephone_number": "541-323-3477"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1011 SW EMKAY DR",
"city": "BEND",
"state": "OR",
"postal_code": "977023162",
"telephone_number": "541-323-3477"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARRIS",
"first_name": "SOPHIA",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-11-27",
"last_updated": "2021-08-31",
"certification_date": "2021-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OR",
"license": "L10555",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SOPHIA",
"last_name": "VISADA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.