Organization Active NPI

Susan Metcalfe LCSW LLC

  • Community/Behavioral Health Agency
  • Beaverton, OR
National Provider Identifier
1639775497
Registry record updated Dec 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
SUSAN METCALFE LCSW LLC
Practice address
10700 SW Beaverton Hillsdale Hwy Ste 460
Beaverton, OR 97005-4736
Phone
(503) 476-6070
NPI assigned
Dec 8, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2020

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

Authorized official

Name
Susan MetcalfeNPI 1922573344
Title
Owner
Phone
(503) 476-6070

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

10700 SW Beaverton Hillsdale Hwy Ste 460
Beaverton, OR 97005-4736

Mailing address

10700 SW Beaverton Hillsdale Hwy Ste 460
Beaverton, OR 97005-4736

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210202002577 OR Part B Supplier - Clinic/Group Practice 1456765403 Receives reassigned benefits from 1 practitioner
Practice locations: Beaverton, OR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1607385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607385600000",
    "number": "1639775497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10700 SW BEAVERTON HILLSDALE HWY STE 460",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970054736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10700 SW BEAVERTON HILLSDALE HWY STE 460",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970054736",
            "telephone_number": "503-476-6070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN METCALFE LCSW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-08",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A",
        "authorized_official_last_name": "METCALFE",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-476-6070"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.