Individual provider Active NPI

Jean E Schumer, LCSW, PHD

  • Clinical Social Worker
  • Corvallis, OR
National Provider Identifier
1720204142
Registry record updated Jan 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L4275 Issued in OR
Practice address
216 NW 6TH St
Corvallis, OR 97330
Phone
(541) 708-3861
NPI assigned
Apr 17, 2007
Last updated
Jan 24, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2019

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 L4275 OR Primary

Addresses

Primary practice location

216 NW 6TH St
Corvallis, OR 97330

Mailing address

216 NW 6TH St
Corvallis, OR 97330-4812
Phone (541) 708-3861

Other practice location 1

1086 7th Ave SW Ste 101
Albany, OR 97321-1954
Phone (541) 812-3330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • 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
I20141230001431 OR Practitioner - Clinical Social Worker 0244553170 Practice locations: Corvallis, OR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
L4275ORMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548288000000",
    "number": "1720204142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 NW 6TH ST",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973304812",
            "telephone_number": "541-708-3861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 NW 6TH ST",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "97330",
            "telephone_number": "541-708-3861"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1086 7th Ave SW Ste 101",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "OR",
            "postal_code": "973211954",
            "country_code": "US",
            "telephone_number": "541-812-3330",
            "fax_number": "541-812-3342",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHUMER",
        "first_name": "JEAN",
        "middle_name": "E",
        "credential": "LCSW, PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2019-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L4275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

Verify at the official NPI Registry.