Active NPI
Petr N Lokotkov, LCSW
- Clinical Social Worker
- Salem, OR
National Provider Identifier
1548540875
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- NO. 062326
- Practice address
- 161 High St SE Ste 231
Salem, OR 97301-3620 - Phone
- (503) 400-7126
- NPI assigned
- Aug 17, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | NO. 062326 | OR | Primary |
Addresses
Primary practice location
161 High St SE Ste 231
Salem, OR 97301-3620
Mailing address
5945 Sagrada St N
Keizer, OR 97303-3785
Phone (503) 400-7126
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
| License | State | Type | Specialty |
|---|---|---|---|
| NO. 062326 | OR | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1313539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1313539200000",
"number": "1548540875",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5945 SAGRADA ST N",
"city": "KEIZER",
"state": "OR",
"postal_code": "973033785",
"telephone_number": "503-400-7126"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "161 HIGH ST SE STE 231",
"city": "SALEM",
"state": "OR",
"postal_code": "973013620",
"telephone_number": "503-400-7126"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOKOTKOV",
"first_name": "PETR",
"middle_name": "N",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-08-17",
"last_updated": "2011-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OR",
"license": "NO. 062326",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.