NPIMap

Organization Active NPI

Inner Courage LLC

  • Clinical Social Worker
  • Portland, OR
National Provider Identifier
1700906047
Registry record updated Mar 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2953 Issued in OR
Legal business name
INNER COURAGE LLC
Practice address
21 NE Alberta St
Portland, OR 97211-2601
Phone
(503) 341-4325
NPI assigned
Mar 30, 2007
Last updated
Mar 28, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2014

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

Authorized official

Name
Carol Maker, LCSWNPI 1316367758
Title
Member
Phone
(503) 341-4325

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 2953 OR
Addiction (Substance Use Disorder) Counselor 101YA0400X 2953 OR
Mental Health Counselor 101YM0800X 2953 OR
Social Worker 104100000X 2953 OR
Clinical Social Worker 1041C0700X 2953 OR Primary
Marriage & Family Therapist 106H00000X 2953 OR

Addresses

Primary practice location

21 NE Alberta St
Portland, OR 97211-2601

Mailing address

21 NE Alberta St
Portland, OR 97211-2601
Phone (503) 341-4325

Other identifiers 1

IdentifierTypeStateIssuer
808138000OtherORREGENCE BCBS OF OREGON

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395964800000",
    "number": "1700906047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 NE ALBERTA ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972112601",
            "telephone_number": "503-341-4325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 NE ALBERTA ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972112601",
            "telephone_number": "503-341-4325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNER COURAGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2014-03-28",
        "status": "A",
        "authorized_official_last_name": "MAKER",
        "authorized_official_first_name": "CAROL",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "503-341-4325",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OR",
            "license": "2953",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "2953",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "2953",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OR",
            "license": "2953",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "2953",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OR",
            "license": "2953",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BCBS OF OREGON",
            "identifier": "808138000",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2014; 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.