Individual provider Active NPI

Kadriliis Speek, MSW

  • Clinical Social Worker
  • Portland, OR
National Provider Identifier
1629264262
Registry record updated Nov 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L10970 Issued in OR
Practice address
1715 SE 32ND Place
Portland, OR 97214
Phone
(503) 234-9591
NPI assigned
Sep 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Clinical Social Worker 1041C0700X L10970 OR Primary

Addresses

Primary practice location

1715 SE 32ND Place
Portland, OR 97214

Mailing address

3415 SE Powell Blvd.
Portland, OR 97202
Phone (503) 234-9591

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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

Enrollment IDStateProvider typePAC IDDetails
I20250228000462 OR Practitioner - Clinical Social Worker 7214457654 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Western Psychological and Counseling Services LLCGroup PAC ID 7719975085, 331 clinicians

Practice addresses (Care Compare)

4224 NE Halsey St
Suite 335
Portland, OR 97213-1568
Phone (503) 992-6616

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L10970ORMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Western Psychological and Counseling Services LLC Social Worker CurrentSince Jan 24, 2025 Accepting new patients
Western Psychological and Counseling Services LLC CurrentSince Jan 24, 2025 Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

880 82nd Dr
Gladstone, OR 97027
Phone (503) 626-9494

4224 NE Halsey St
Ste 335
Portland, OR 97213
Phone (503) 922-6616

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1190073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1629264262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3415 SE POWELL BLVD.",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97202",
            "telephone_number": "503-234-9591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 SE 32ND PLACE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97214",
            "telephone_number": "503-234-9591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPEEK",
        "first_name": "KADRILIIS",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-18",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "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": "L10970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.