Individual provider Active NPI

Susan Anne Witt, LCSW, CADC1

  • Clinical Social Worker
  • Hood River, OR
National Provider Identifier
1649325580
Registry record updated May 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L2419 Issued in OR
Practice address
702 Columbia St
Hood River, OR 97031-1720
Phone
(541) 490-5831
NPI assigned
Jan 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 03-03-46 OR
Clinical Social Worker 1041C0700X L2419 OR Primary

Addresses

Primary practice location

702 Columbia St
Hood River, OR 97031-1720

Mailing address

PO Box 1245
Hood River, OR 97031-0083
Phone (541) 490-5831

Other identifiers 1

IdentifierTypeStateIssuer
500674555MedicaidOR

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
I20190625000240 OR Practitioner - Clinical Social Worker 9537493671 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

702 Columbia St
Hood River, OR 97031-1720
Phone (541) 490-5831

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L2419ORMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Inner Pathways PC Addiction (Substance Use Disorder) CurrentSince Oct 19, 2012 Accepting new patients
Mid-Columbia Center for Living PastSince Jun 15, 2021 Accepting new patients
Mid-Columbia Center for Living Past Accepting new patients
Hood River Counseling, PC Addiction (Substance Use Disorder) PastSince May 4, 2019 Accepting new patients
Mid-Columbia Center for Living Addiction (Substance Use Disorder) PastSince Sep 2, 2014 Accepting new patients

Locations

702 Columbia St
Hood River, OR 97031
Phone (541) 490-5831

Organizations & group practices 5

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": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558051200000",
    "number": "1649325580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1245",
            "city": "HOOD RIVER",
            "state": "OR",
            "postal_code": "970310083",
            "telephone_number": "541-490-5831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 COLUMBIA ST",
            "city": "HOOD RIVER",
            "state": "OR",
            "postal_code": "970311720",
            "telephone_number": "541-490-5831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITT",
        "first_name": "SUSAN",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "LCSW, CADC1",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2019-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "03-03-46",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L2419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500674555",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hood River, OR

Sources for this page

Verify at the official NPI Registry.