Susan H Dawdy, 1041C0700X

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L7014 Issued in OR

Practice address

4241 SE 15TH Ave
Portland, OR 97202-3927

Phone

(413) 281-5130

Fax

(413) 961-2574

NPI assigned

Feb 7, 2007

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

Medicare fee-for-service enrollment

Enrolled in MA, OR2 enrollments

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 2

Specialty

Clinical Social Worker

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mindful Therapy Group PCGroup PAC ID 4981872561, 654 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Mindful Therapy Group PC

  • Clinical Social Worker
  • Mountlake Terrace, WA
  • NPI 1316238678

  OR

  Medicare reassignment Care Compare group NPD
• Clinical & Support Options, Inc

  • Community/Behavioral Health Agency
  • Greenfield, MA
  • NPI 1831265115
  Medicare reassignment NPD

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597708800000",
    "number": "1619017142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4241 SE 15TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972023927",
            "telephone_number": "413-281-5130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4241 SE 15TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972023927",
            "telephone_number": "413-281-5130",
            "fax_number": "413-961-2574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAWDY",
        "first_name": "SUSAN",
        "middle_name": "H",
        "credential": "1041C0700X",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L7014",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MA",
            "license": "113862",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shari Davison, M.A., LMFT
• Heidi Petra Davisson, MA
• James S Davitt, MD
• Andrew Alex Davoodian, MD, MBA
• Teni Davoudian, PH.D., ABPP
• Wendy Dawdy
• Maura Dawgert
• Douglas Lee Dawley, MD
• Dawn Moeller L.Ac. LLC
• Presha Dawn, L.M.T.

• 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 Aug 18, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.