Active NPI
Grace Whitty, CSWA
- Clinical Social Worker
- Gresham, OR
National Provider Identifier
1700655099
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- A14264
- Practice address
- 649 NE Hood Ave
Gresham, OR 97030-7328 - Phone
- (971) 404-4668
- NPI assigned
- Dec 27, 2023
- Last updated
- Dec 27, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | A14264 | OR | Primary |
Addresses
Primary practice location
649 NE Hood Ave
Gresham, OR 97030-7328
Mailing address
1814 SW Moss St
Portland, OR 97219-2743
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A14264 | OR | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Connected Space Counseling, LLC | Clinical | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1703635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1703635200000",
"number": "1700655099",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1814 SW MOSS ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972192743"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "649 NE HOOD AVE",
"city": "GRESHAM",
"state": "OR",
"postal_code": "970307328",
"telephone_number": "971-404-4668"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITTY",
"first_name": "GRACE",
"credential": "CSWA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-12-27",
"last_updated": "2023-12-27",
"certification_date": "2023-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OR",
"license": "A14264",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gresham, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.