Active NPI
Chelsea Cynthia Holcomb, LCSW
- Clinical Social Worker
- Portland, OR
National Provider Identifier
1609004555
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 25976
- Practice address
- 722 NE 162ND Ave
Portland, OR 97230-5760 - Phone
- (503) 460-7022
- NPI assigned
- Jun 30, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 25976 | CA | Primary |
| Clinical Social Worker | 1041C0700X | LW 60022340 | WA |
Addresses
Primary practice location
722 NE 162ND Ave
Portland, OR 97230-5760
Mailing address
722 NE 162ND Ave
Portland, OR 97230-5760
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LW 60022340 | WA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1246320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1300233600000",
"number": "1609004555",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "722 NE 162ND AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972305760"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "722 NE 162ND AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972305760",
"telephone_number": "503-460-7022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLCOMB",
"first_name": "CHELSEA",
"middle_name": "CYNTHIA",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-06-30",
"last_updated": "2011-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "25976",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WA",
"license": "LW 60022340",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.