Individual provider Active NPI

Alicia Mangiaracina Schmidt, LCSW

  • Mental Health Counselor
  • Medford, OR
National Provider Identifier
1467844100
Registry record updated Jun 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
3617 S Pacific Hwy
Medford, OR 97501-8957
Phone
(541) 535-6239
Fax
(541) 512-1026
NPI assigned
Mar 3, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

3617 S Pacific Hwy
Medford, OR 97501-8957

Mailing address

3617 S Pacific Hwy
Medford, OR 97501-8957
Phone (541) 535-6239

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
I20220913000706 OR Practitioner - Clinical Social Worker 8820420383 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
Telehealth
Offers telehealth services
Group practices
Bridges to Wellbeing LLCGroup PAC ID 1951785054, 3 clinicians

Practice addresses (Care Compare)

10 S Bartlett St
Suite 204
Medford, OR 97501-7204
Phone (541) 631-6087

1314 Ctr Dr
Suite B406
Medford, OR 97501

PO Box
Suite 935
Medford, OR 97501-0067

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bridges to Wellbeing LLC Mental Health CurrentSince Aug 26, 2021 Accepting new patients
Amy Sloper LPC LLC Past Accepting new patients

Locations

10 S Bartlett St
Ste 204
Medford, OR 97501
Phone (541) 631-6087

Organizations & group practices 2

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": "1425340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559520000000",
    "number": "1467844100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3617 S PACIFIC HWY",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975018957",
            "telephone_number": "541-535-6239",
            "fax_number": "541-512-1026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3617 S PACIFIC HWY",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975018957",
            "telephone_number": "541-535-6239",
            "fax_number": "541-512-1026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMIDT",
        "first_name": "ALICIA",
        "middle_name": "MANGIARACINA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-03",
        "last_updated": "2019-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.