Individual provider Active NPI

Brigett W Hollander, LCSW

  • Clinical Social Worker
  • Coos Bay, OR
National Provider Identifier
1578735270
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-28501 Issued in ID
Practice address
444 N 4TH St
Coos Bay, OR 97420-2222
Phone
(541) 337-1856
NPI assigned
Apr 2, 2008
Last updated
Dec 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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 LCSW-28501 ID Primary

Addresses

Primary practice location

444 N 4TH St
Coos Bay, OR 97420-2222

Mailing address

2354 Union Ave
North Bend, OR 97459-3355
Phone (541) 337-1856

Other identifiers 2

IdentifierTypeStateIssuer
000010165686OtherIDREGENCE BLUE SHIELD
L6078OtherIDBLUE CROSS OF IDAHO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201020003612 OR Practitioner - Clinical Social Worker 9931224912 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2354 Union Ave
North Bend, OR 97459-3355
Phone (541) 337-1856

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-28501IDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Roseburg Therapy LLC Clinical CurrentSince Aug 1, 2022 Accepting new patients
Waterfall Clinic, Incorporated CurrentSince Aug 31, 2020 Accepting new patients
Waterfall Clinic Incorporated CurrentSince Aug 31, 2020 Accepting new patients
Lifespan Counseling and Consulting LLC CurrentSince Aug 2, 2023 Accepting new patients
Ascent Behavioral Health Services Past Accepting new patients
Ascent Behavioral Health Services Past Accepting new patients

Locations

444 N 4th St
Coos Bay, OR 97420
Phone (541) 337-1856

1890 Waite St
Ste 1
North Bend, OR 97459
Phone (541) 435-7033

272 NW Medical Loop
Ste E
Roseburg, OR 97471
Phone (541) 677-6141

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1207094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1578735270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2354 UNION AVE",
            "city": "NORTH BEND",
            "state": "OR",
            "postal_code": "974593355",
            "telephone_number": "541-337-1856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 N 4TH ST",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202222",
            "telephone_number": "541-337-1856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLANDER",
        "first_name": "BRIGETT",
        "middle_name": "W",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-02",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-28501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "000010165686",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "L6078",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coos Bay, OR

Sources for this page

Verify at the official NPI Registry.