Sonja Charlene Crisosto, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L11236 Issued in OR

Practice address

4224 NE Halsey St Ste 335
Portland, OR 97213-1568

Phone

(503) 922-6616

NPI assigned

Mar 13, 2013

Last updated

Feb 5, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1363132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1598006728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7509 NE PACIFIC ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972136274",
            "telephone_number": "971-212-9843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4224 NE HALSEY ST STE 335",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972131568",
            "telephone_number": "503-922-6616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRISOSTO",
        "first_name": "SONJA",
        "middle_name": "CHARLENE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-13",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L11236",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "P4723",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniela Crisan, PHARMD
• Delphine Criscenzo
• Nicole Jeanine Crise
• Mark Alden Crislip, MD
• Angela Kelly Crisman, MA
• Kara Crisp, N.D.
• Kathy Ann Crispell, MD
• Julie A Crispin, L.M.T.
• Audrey A Crist, MD
• Marsha Sharyn Cristales-Fontaine

• Clinical Social Worker in Portland, OR
• Providers in Portland, 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 Feb 5, 2024; 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.