Anissa Renee Bahrenburg, LCSW
Individual provider Active NPI Clinical Social Worker · Portland, OR
NPI 1558080713 · NPPES record last updated Aug 23, 2022
Key facts
- NPI
- 1558080713
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 4419 (OR)
- Practice address
- 2133 NE Broadway St Ste 303
Portland, OR 97232-1878 - Phone
- (503) 807-2912
- NPI assigned
- Aug 23, 2022
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4419 | OR | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 4419 | OR | Yes |
Addresses
Primary practice location
2133 NE Broadway St Ste 303
Portland, OR 97232-1878
Mailing address
8040 SE 35TH Ave
Portland, OR 97202-8414
Phone (503) 807-2912
Other providers in Portland, OR
- Alexandra Marie Bahling
- Rhonda Bahmanyar
- Alison Kim Bahr
- Petra Bahr
- Jaye Bahre
- William Stewart Bahrenburg III
- Chresteen Bahsous
- Zachary Baier
- Shahana Falah Baig-Lewis
- Baihui Acupuncture & Herbs LLC
All providers in Portland, OR · Clinical Social Worker in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 23, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.