Shannon Coffaro
Individual provider Active NPI Clinical Social Worker · Seaside, OR
NPI 1699409755 · NPPES record last updated Sep 18, 2025
Key facts
- NPI
- 1699409755
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 100968 (CA)
- Practice address
- 1005 Broadway St
Seaside, OR 97138-7845 - Phone
- (503) 325-5722
- NPI assigned
- Jul 14, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2007
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Clatsop Behavioral Healthcare
Practice addresses (Care Compare)
115 W Bond St
Astoria, OR 97103-6009
Phone 5033255722268
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251017002484 | OR | Practitioner - Clinical Social Worker | 8921595380 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 100968 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clatsop Behavioral Healthcare | Current |
Accepting new patients |
Locations
115 W Bond St
Astoria, OR 97103
Phone 5033255722268
65 N Highway 101
Ste 204
Warrenton, OR 97146
Interoperability endpoints
- https://api.qualifacts.org/api/fhir/clatsopbh/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 100968 | CA | Yes |
Addresses
Primary practice location
1005 Broadway St
Seaside, OR 97138-7845
Mailing address
65 N Highway 101 Ste 204
Warrenton, OR 97146-9371
Phone (503) 325-5722
Other providers in Seaside, OR
- Jeffrey Chow
- City of Seaside
- Coastal Breeze Recovery, LLC
- Coda, Inc.
- Michael Ray Coddington
- Columbia Lutheran Charities
- Columbia Lutheran Charities
- Jillian Conrad
- Willow Morningstar Creel
- Carol L Crowe
All providers in Seaside, OR · Clinical Social Worker in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 18, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.