Sovalti LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

SOVALTI LLC

Practice address

12505 NE Halsey St
Portland, OR 97230-1928

Phone

(971) 279-7439

Fax

(503) 774-4167

NPI assigned

Mar 4, 2019

Organization subpart

No

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

Authorized official

Name

Timisha K Wilson, LCSWNPI 1932687233

Title

Clinical Director

Phone

(971) 279-7439

Specialties & licenses 4

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Timisha K Wilson, MSW

  • Clinical Social Worker
  • Portland, OR
  • NPI 1932687233
  NPD (past) Authorized official

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

{
    "created_epoch": "1551657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586908800000",
    "number": "1710445218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12765",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972120765",
            "fax_number": "503-774-4167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12505 NE HALSEY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972301928",
            "telephone_number": "971-279-7439",
            "fax_number": "503-774-4167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOVALTI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-04",
        "last_updated": "2020-04-15",
        "certification_date": "2020-04-15",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "TIMISHA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "971-279-7439",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kambria Souza
• Katherine Souza, ND, LAC, LMT
• Maddison Souza, PA-C
• Phoebe Milan Souza, MSW, LCSW, MPH
• Myah Rowan Sova, CADC R
• Justin Sovich
• Spa Sasse LLC
• Spa Willamina
• Kent Alan Spackman, M.D.
• Marla Kay Spadafora, RN

• Clinical Social Worker in Portland, OR
• Providers in Portland, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2020; 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.