Individual provider Active NPI

Laurie A Koski, LCSW

  • Clinical Social Worker
  • Bend, OR
National Provider Identifier
1740418805
Registry record updated Feb 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L3966 Issued in OR
Practice address
2789 NE Red Oak Dr
Bend, OR 97701-8348
Phone
(541) 647-7626
NPI assigned
Jun 29, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2024

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 L3966 OR Primary

Addresses

Primary practice location

2789 NE Red Oak Dr
Bend, OR 97701-8348

Mailing address

2789 NE Red Oak Dr
Bend, OR 97701-8348
Phone (541) 647-7626

Other names 1

  • Laurie A Towner Former name

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
I20101210000402 OR Practitioner - Clinical Social Worker 5597952952 Practice locations: Bend, OR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2789 NE Red Oak Dr
Bend, OR 97701-8348
Phone (541) 647-7626

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L3966ORMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1246233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1740418805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2789 NE RED OAK DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977018348",
            "telephone_number": "541-647-7626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2789 NE RED OAK DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977018348",
            "telephone_number": "541-647-7626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSKI",
        "first_name": "LAURIE",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-29",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L3966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURIE",
            "last_name": "TOWNER",
            "middle_name": "A",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.