Andrew Marcus Delgado, LCSW
Individual provider Active NPI Clinical Social Worker · Fortuna, CA
NPI 1518368331 · NPPES record last updated Jan 22, 2020
Key facts
- NPI
- 1518368331
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- LCSW87293 (CA)
- Practice address
- 3750 Rohnerville Road
Fortuna, CA 95540 - Phone
- (707) 725-6101
- Fax
- (707) 725-2978
- NPI assigned
- Sep 11, 2014
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Cow Creek Band of Umpqua Tribe of Indians
Practice addresses (Care Compare)
480 Wartahoo LN
Cow Creek HLTH and Wellness Ctr
Canyonville, OR 97417-9683
Phone (541) 839-1345
Merit-based Incentive Payment System (MIPS)
- Final score
- 92 of 100
- Quality
- 84.7
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 79.21
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in CA, TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200313001409 | CA | Practitioner - Clinical Social Worker | 8729306337 | Practice locations: Arcata, CA |
| I20201111002089 | TX | Practitioner - Clinical Social Worker | 8729306337 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW87293 | CA | MD | Clinical Social Worker |
| L6320 | OR | MD | Clinical Social Worker |
| 87293 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Portland Adventist Medical Center | Current |
Accepting new patients | |
| Portland Adventist Medical Center | Current |
Accepting new patients | |
| Cow Creek Band of Umpqua Tribe of Indians | Current |
Accepting new patients | |
| Cow Creek Band of Umpqua Tribe of Indians | Current |
Accepting new patients |
Locations
10151 SE Sunnyside Rd
Ste 100
Clackamas, OR 97015
Phone (503) 659-0880
14450 SE Royer Rd
Damascus, OR 97089
Phone (503) 658-5521
831 NW Council Dr
Ste 125
Gresham, OR 97030
Phone (503) 661-3439
831 NW Council Dr
Ste 101
Gresham, OR 97030
Phone (503) 665-8176
500 SE Cass Ave
Ste 110
Roseburg, OR 97470
Phone (541) 677-5520
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | L6320 | OR | |
| Clinical Social Worker | 1041C0700X | LCSW87293 | CA | Yes |
| Clinical Social Worker | 1041C0700X | L6320 | OR |
Addresses
Primary practice location
3750 Rohnerville Road
Fortuna, CA 95540
Mailing address
PO Box 1045
Arcata, CA 95518-1045
Phone (707) 572-9440
Other providers in Fortuna, CA
- David J. D'Amico Chiropractic, Inc.
- Britain Kalob Davis
- Brent C Dawson
- Imelda De Los Santos
- Danilo Santiago Dela Cruz
- Stephanie L Demara
- Dickerson Solution
- Dionysos Durand Dickerson
- Vanessa Nicole Dickerson
- Patricia Dillon
All providers in Fortuna, CA · Clinical Social Worker in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.