Individual provider Active NPI

Jana Lea Kreofsky, M.S.W., LCSW

  • Clinical Social Worker
  • Portland, OR
National Provider Identifier
1528403599
Registry record updated Apr 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
232 NW 6TH Ave
Portland, OR 97209-3609
Phone
(503) 228-7134
NPI assigned
May 5, 2013
Last updated
Apr 3, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2018

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 NU Primary

Addresses

Primary practice location

232 NW 6TH Ave
Portland, OR 97209-3609

Mailing address

232 NW 6TH Ave
Portland, OR 97209-3609
Phone (503) 228-7134

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Dec 24, 2023 through Dec 24, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1367712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522713600000",
    "number": "1528403599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "232 NW 6TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972093609",
            "telephone_number": "503-228-7134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "232 NW 6TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972093609",
            "telephone_number": "503-228-7134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREOFSKY",
        "first_name": "JANA",
        "middle_name": "LEA",
        "credential": "M.S.W., LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-05",
        "last_updated": "2018-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.