Mollie Elizabeth Cudmore, MSW
Individual provider Active NPI Clinical Social Worker · Joseph, OR
NPI 1427499656 · NPPES record last updated Jan 4, 2024
Key facts
- NPI
- 1427499656
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- Practice address
- 62606 Hurricane Creek Rd
Joseph, OR 97846-8109 - Phone
- (541) 805-1606
- NPI assigned
- Jul 16, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Mindful Therapy Group PC
Practice addresses (Care Compare)
11740 SW 68TH Pkwy
Suite 200
Tigard, OR 97223-9058
Phone (971) 352-6984
62606 Hurricane Creek Rd
Joseph, OR 97846-8109
Phone (541) 805-1606
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170110002616 | OR | Practitioner - Clinical Social Worker | 0547541328 |
Reassigns benefits to 2 organizations Practice locations: Joseph, OR |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wallowa Valley Center for Wellness | Current |
Accepting new patients | |
| Mindful Therapy Group PC | Clinical | Current |
Accepting new patients |
| MB Counseling LLC | Clinical | Past | Accepting new patients |
Locations
103 Highway 82
Ste D
Enterprise, OR 97828
Phone (541) 426-4524
5440 SW Westgate Dr
Ste 350
Portland, OR 97221
Phone (503) 292-1100
11740 SW 68th Pkwy
Ste 200
Tigard, OR 97223
Phone (425) 477-4216
6505 216th St SW
Ste 100
Mountlake Terrace, WA 98043
Phone (425) 678-6463
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Yes |
Addresses
Primary practice location
62606 Hurricane Creek Rd
Joseph, OR 97846-8109
Mailing address
62606 Hurricane Creek Rd
Joseph, OR 97846-8109
Phone (541) 805-1606
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1020986 | Medicaid | AK |
Other providers in Joseph, OR
- Blue Butterfly Services LLC
- R. Devee Boyd
- Kirsten Elizabeth Tallent Caine
- Sandra N Catlin
- Chief Joseph Dental Clinic, LLC
- Kuulei Delatori
- Risa Frank
- Traci M. Frye
- Amy Jacqueline Gulzow
- Charles Jeffrey Harman
All providers in Joseph, OR · Clinical Social Worker in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 4, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.