Individual provider Active NPI

Laurel Diane Oziel, MSW,LCSW,QMHP

  • Clinical Social Worker
  • Portland, OR
National Provider Identifier
1639187750
Registry record updated Nov 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L3169 Issued in OR
Practice address
720 SW Washington St
Suite 628
Portland, OR 97205-3519
Phone
(503) 421-0471
Fax
(503) 954-3254
NPI assigned
Aug 4, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X L3169 OR Primary

Addresses

Primary practice location

720 SW Washington St
Suite 628
Portland, OR 97205-3519

Mailing address

720 SW Washington St
Suite 628
Portland, OR 97205-3519
Phone (503) 421-0471

Other names 1

  • Laurel Diane Puziss Former name

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
I20040602000190 OR Practitioner - Clinical Social Worker 1254313570 Practice locations: Tigard, OR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

Tigard, OR 97223
Phone (503) 421-0471

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L3169ORMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320278400000",
    "number": "1639187750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 SW WASHINGTON ST",
            "address_2": "SUITE 628",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972053519",
            "telephone_number": "503-421-0471",
            "fax_number": "503-954-3254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 SW WASHINGTON ST",
            "address_2": "SUITE 628",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972053519",
            "telephone_number": "503-421-0471",
            "fax_number": "503-954-3254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OZIEL",
        "first_name": "LAUREL",
        "middle_name": "DIANE",
        "credential": "MSW,LCSW,QMHP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2011-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L3169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREL",
            "last_name": "PUZISS",
            "middle_name": "DIANE",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.