Susan M. Bernt, M.S.W., LCSW, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW60084972 Issued in WA

Practice address

2118 19TH St
#19
West Linn, OR 97068

Phone

(503) 819-7095

Fax

(503) 328-7994

NPI assigned

Jan 29, 2007

Last updated

Dec 28, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Mindful, Inc

  • Clinical Social Worker
  • Vancouver, WA
  • NPI 1932307683
  NPD (past)

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640649600000",
    "number": "1588700280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 462",
            "city": "GLADSTONE",
            "state": "OR",
            "postal_code": "970270462",
            "telephone_number": "503-819-7095",
            "fax_number": "503-328-7994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2118 19TH ST",
            "address_2": "#19",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "97068",
            "telephone_number": "503-819-7095",
            "fax_number": "503-328-7994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNT",
        "first_name": "SUSAN",
        "middle_name": "M.",
        "credential": "M.S.W., LCSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "4288",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60084972",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1588700280",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan Lambert Bellacov, D.C.
• Benchmark Physical Therapy of Or, LLC
• Jeni Bennett
• Mary Bergeron
• Robert James Bergstrom, DMD
• Tiffany Marie Bieker, LMT
• Big Tooth Little Tooth Pediatric Dentistry PC
• Mo Biria, DMD
• Rose Marie Blacklidge, LMT
• Lori J Blain, DC

• Clinical Social Worker in West Linn, OR
• Providers in West Linn, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.