NPIMap

Organization Active NPI

Shoreline Counseling LLC

  • Clinical Social Worker
  • Astoria, OR
National Provider Identifier
1437548807
Registry record updated Jan 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L6292 Issued in OR
Legal business name
SHORELINE COUNSELING LLC
Practice address
10 Pier 1 Ste 204
Astoria, OR 97103-6328
Phone
(503) 789-6850
NPI assigned
Jan 22, 2015
Last updated
Jan 22, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2015

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

Authorized official

Name
Sarah Von ColditzNPI 1104224393
Title
LCSW
Phone
(503) 789-6850

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X L6292 OR Primary

Addresses

Primary practice location

10 Pier 1 Ste 204
Astoria, OR 97103-6328

Mailing address

10 Pier 1 Ste 204
Astoria, OR 97103-6328
Phone (503) 789-6850

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150609001749 OR Part B Supplier - Clinic/Group Practice 4587985049 Receives reassigned benefits from 33 practitioners
Practice locations: Astoria, OR

National Provider Directory

National Provider Directory

Locations

10 Pier 1
Ste 203
Astoria, OR 97103
Phone (503) 789-6850

10 Pier 1
Ste 204
Astoria, OR 97103
Phone (503) 789-6850

Practitioners & affiliated clinicians

Practitioners 45

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1421884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421884800000",
    "number": "1437548807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 PIER 1 STE 204",
            "city": "ASTORIA",
            "state": "OR",
            "postal_code": "971036328",
            "telephone_number": "503-789-6850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 PIER 1 STE 204",
            "city": "ASTORIA",
            "state": "OR",
            "postal_code": "971036328",
            "telephone_number": "503-789-6850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORELINE COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-22",
        "last_updated": "2015-01-22",
        "status": "A",
        "authorized_official_last_name": "VON COLDITZ",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "LCSW",
        "authorized_official_telephone_number": "503-789-6850"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L6292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.