Individual provider Active NPI

Pamela Borreson, LCSW

  • Clinical Social Worker
  • Grants Pass, OR
National Provider Identifier
1508614785
Registry record updated May 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L10600 Issued in OR
Practice address
2223 Gayle Way
Grants Pass, OR 97527-4262
Phone
(541) 232-3237
NPI assigned
May 10, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X L10600 OR Primary

Addresses

Primary practice location

2223 Gayle Way
Grants Pass, OR 97527-4262

Mailing address

1055 Redwood Ave
Grants Pass, OR 97527-5525
Phone (541) 479-0545

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
L10600ORMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1715299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715299200000",
    "number": "1508614785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 REDWOOD AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275525",
            "telephone_number": "541-479-0545",
            "fax_number": "542-479-4271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2223 GAYLE WAY",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975274262",
            "telephone_number": "541-232-3237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORRESON",
        "first_name": "PAMELA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-10",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L10600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grants Pass, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.