Individual provider Active NPI

Patrice M Barreto, LCSW

  • Clinical Social Worker
  • La Grande, OR
National Provider Identifier
1487664116
Registry record updated Jun 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L3526 Issued in OR
Practice address
1606 6TH St
La Grande, OR 97850-2520
Phone
(541) 963-7289
Fax
(541) 962-7289
NPI assigned
Aug 8, 2006
Last updated
Jun 24, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X L3526 OR Primary
School Social Worker 1041S0200X L3526 OR

Addresses

Primary practice location

1606 6TH St
La Grande, OR 97850-2520

Mailing address

PO Box 1005
La Grande, OR 97850-1005
Phone (541) 963-7289

Other identifiers 1

IdentifierTypeStateIssuer
831399002OtherORREGENCE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 1, 2022 through Apr 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L3526ORMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214265600000",
    "number": "1487664116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1005",
            "city": "LA GRANDE",
            "state": "OR",
            "postal_code": "978501005",
            "telephone_number": "541-963-7289",
            "fax_number": "541-963-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1606 6TH ST",
            "city": "LA GRANDE",
            "state": "OR",
            "postal_code": "978502520",
            "telephone_number": "541-963-7289",
            "fax_number": "541-962-7289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRETO",
        "first_name": "PATRICE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2008-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L3526",
            "primary": true
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "OR",
            "license": "L3526",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "831399002",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Grande, OR

Sources for this page

Verify at the official NPI Registry.