Individual provider Active NPI

Teresa Enigma, MSW, LCSW

  • Clinical Social Worker
  • Portland, OR
National Provider Identifier
1700355138
Registry record updated Jan 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L10703 Issued in OR
Practice address
209 SW 4TH Ave Ste 520
Portland, OR 97204-1825
Phone
(503) 988-1082
Fax
(503) 988-4015
NPI assigned
Nov 14, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X L10703 OR Primary

Addresses

Primary practice location

209 SW 4TH Ave Ste 520
Portland, OR 97204-1825

Mailing address

209 SW 4TH Ave Ste 520
Portland, OR 97204-1825
Phone (503) 988-1082

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: No
  • 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
I20210913002495 OR Practitioner - Clinical Social Worker 8921404138 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L10703ORMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Multnomah County CurrentSince Jan 5, 2025 Accepting new patients
Multnomah County Current Accepting new patients
Multnomah County CurrentSince Jan 5, 2025 Accepting new patients

Locations

600 NE 8th St
Gresham, OR 97030
Phone (503) 988-4900

209 SW 4th Ave
Ste 210
Portland, OR 97204
Phone (503) 988-3674

619 NW 6th Ave
Fl 5
Portland, OR 97209
Phone (503) 988-3674

619 NW 6th Ave
Portland, OR 97209
Phone (503) 988-3674

209 SW 4th Ave
Ste 520
Portland, OR 97204
Phone (503) 988-5464

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": "1542153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1700355138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 SW 4TH AVE STE 520",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972041825",
            "telephone_number": "503-988-1082",
            "fax_number": "503-988-4015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 SW 4TH AVE STE 520",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972041825",
            "telephone_number": "503-988-1082",
            "fax_number": "503-988-4015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENIGMA",
        "first_name": "TERESA",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-14",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L10703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.