Chanda Maureen Driscoll, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L6154 Issued in OR

Practice address

2965 NE Conners Ave
Suite 280
Bend, OR 97701-7753

Phone

(541) 323-4269

Fax

(541) 383-1883

NPI assigned

Jul 7, 2010

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Bend Memorial Clinic PC

  dba Summit Health

  • Family Medicine Physician
  • Bend, OR
  • NPI 1699827477
  NPD (past)
• Cascade Internal Medicine PS

  • Psychiatry Physician
  • Tacoma, WA
  • NPI 1700853983
  NPD (past)

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

{
    "created_epoch": "1278460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477267200000",
    "number": "1588976559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 SW COLUMBIA ST",
            "address_2": "SUITE 6210",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021099",
            "telephone_number": "541-383-3005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2965 NE CONNERS AVE",
            "address_2": "SUITE 280",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977017753",
            "telephone_number": "541-323-4269",
            "fax_number": "541-383-1883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRISCOLL",
        "first_name": "CHANDA",
        "middle_name": "MAUREEN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-07",
        "last_updated": "2016-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AK",
            "license": "596",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L6154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500708564",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Blake Brandt Drew, D.M.D
• Kathleen Drew
• Kimberly Drew, M.A.
• Whitney K Drew, PA-C
• Aleah Driscoll, PA-C
• Driven Enterprises PC
• Robin Droege, LPCI
• Russell Patrick Droll
• Drop Thesis
• Marci Drum

• Clinical Social Worker in Bend, OR
• Providers in Bend, 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 Oct 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.