Individual provider Active NPI

Sandra Winslow Seeley, LCSW CADCI

  • Clinical Social Worker
  • Redmond, OR
National Provider Identifier
1508157413
Registry record updated Jun 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
916 SW 17TH St Ste 202
Redmond, OR 97756-2572
Phone
(541) 706-2768
NPI assigned
Apr 26, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 08-08-57U OR
Mental Health Counselor 101YM0800X L2891 OR
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

916 SW 17TH St Ste 202
Redmond, OR 97756-2572

Mailing address

2500 NE Neff Rd
Bend, OR 97701-6015
Phone (541) 382-4321

Other practice location 1

247 SW 8th St
Redmond, OR 97756-2117
Phone (541) 408-6223

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sseeley14817@secure.stcharleshealthcare.org

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
I20181025002278 OR Practitioner - Clinical Social Worker 3173876844 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Charles Health System IncGroup PAC ID 3870402852, 174 clinicians

Practice addresses (Care Compare)

1253 NW Canal Blvd
Redmond, OR 97756-1334
Phone (541) 548-8131

916 SW 17TH St
Suite 202
Redmond, OR 97756-2572
Phone (541) 706-2768

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L2891ORMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
St. Charles Health System, Inc. Current Accepting new patients
St. Charles Health System, Inc. CurrentSince Nov 1, 2018 Accepting new patients
Nancy Hoffman, LCSW, PC Clinical PastSince Mar 1, 2013 Accepting new patients

Locations

29358 Network Pl
Chicago, IL 60673

2500 NE Neff Rd
Bend, OR 97701
Phone (541) 388-4333

2542 NE Courtney Dr
Bend, OR 97701
Phone (541) 322-2768

360 SW Bond St
Ste 330
Bend, OR 97702
Phone (541) 706-7730

1253 NW Canal Blvd
Redmond, OR 97756
Phone (541) 548-8131

916 SW 17th St
Ste 202
Redmond, OR 97756
Phone (541) 504-0250

Interoperability endpoints

  • Direct secure messaging: sseeley14817@secure.stcharleshealthcare.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1303776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655424000000",
    "number": "1508157413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 NE NEFF RD",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016015",
            "telephone_number": "541-382-4321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "916 SW 17TH ST STE 202",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977562572",
            "telephone_number": "541-706-2768"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "247 SW 8th St",
            "address_purpose": "LOCATION",
            "city": "Redmond",
            "state": "OR",
            "postal_code": "977562117",
            "country_code": "US",
            "telephone_number": "541-408-6223",
            "fax_number": "541-548-6501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEELEY",
        "first_name": "SANDRA",
        "middle_name": "WINSLOW",
        "name_prefix": "Mrs.",
        "credential": "LCSW CADCI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-26",
        "last_updated": "2022-06-17",
        "certification_date": "2022-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "08-08-57U",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "L2891",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sseeley14817@secure.stcharleshealthcare.org",
            "affiliation": "N",
            "address_1": "916 SW 17th St Ste 202",
            "city": "Redmond",
            "state": "OR",
            "country_code": "US",
            "postal_code": "977562572",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Redmond, OR

Sources for this page

Verify at the official NPI Registry.