Individual provider Active NPI

Cecelia W Sanders, LCSW

  • Social Worker
  • Clatskanie, OR
National Provider Identifier
1669696308
Registry record updated Dec 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
L3092 Issued in OR
Practice address
555 SW Bryant
Clatskanie, OR 97016
Phone
(503) 728-2416
Fax
(503) 728-3590
NPI assigned
Apr 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X L3092 OR Primary

Addresses

Primary practice location

555 SW Bryant
Clatskanie, OR 97016

Mailing address

PO Box 1234
Saint Helens, OR 97051-8234
Phone (503) 397-5211

Other identifiers 1

IdentifierTypeStateIssuer
123190MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L3092ORMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Community Mental Health Past Accepting new patients
Columbia Community Mental Health PastSince May 19, 2024 Accepting new patients
Valley Behavioral Health Incorporated Past Accepting new patients

Organizations & group practices 3

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": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196640000000",
    "number": "1669696308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1234",
            "city": "SAINT HELENS",
            "state": "OR",
            "postal_code": "970518234",
            "telephone_number": "503-397-5211",
            "fax_number": "503-397-5373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 SW BRYANT",
            "city": "CLATSKANIE",
            "state": "OR",
            "postal_code": "97016",
            "telephone_number": "503-728-2416",
            "fax_number": "503-728-3590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "CECELIA",
        "middle_name": "W",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2007-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OR",
            "license": "L3092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123190",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clatskanie, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.