Active NPI
Lynne Karen Percevay, LCSW
- Clinical Social Worker
- Salem, OR
National Provider Identifier
1417011362
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- L1750
- Practice address
- 1073 Oak St SE
Salem, OR 97301-4018 - Phone
- (503) 361-2692
- Fax
- (503) 585-4965
- NPI assigned
- Dec 21, 2006
- 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 | L1750 | OR | Primary |
Addresses
Primary practice location
1073 Oak St SE
Salem, OR 97301-4018
Mailing address
3180 Center St NE
Salem, OR 97301-4532
Phone (503) 361-2692
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 |
|---|---|---|---|
| L1750 | OR | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marion County Health Department | Past | Accepting new patients |
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.
-
- Community/Behavioral Health Agency
- Salem, OR
- NPI 1932301173
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166659200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1363219200000",
"number": "1417011362",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3180 CENTER ST NE",
"city": "SALEM",
"state": "OR",
"postal_code": "973014532",
"telephone_number": "503-361-2692",
"fax_number": "503-585-4965"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1073 OAK ST SE",
"city": "SALEM",
"state": "OR",
"postal_code": "973014018",
"telephone_number": "503-361-2692",
"fax_number": "503-585-4965"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERCEVAY",
"first_name": "LYNNE",
"middle_name": "KAREN",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-21",
"last_updated": "2013-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OR",
"license": "L1750",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.