Individual provider Active NPI

Hailey Elisabeth Chamberlain

  • Clinical Social Worker
  • Portland, OR
National Provider Identifier
1750763728
Registry record updated Feb 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L11160 Issued in OR
Practice address
1904 SE Division St
Portland, OR 97202
Phone
(503) 517-8663
NPI assigned
Jun 25, 2015
Last updated
Feb 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU
Clinical Social Worker 1041C0700X L11160 OR Primary

Addresses

Primary practice location

1904 SE Division St
Portland, OR 97202

Mailing address

1904 SE Division St
Portland, OR 97202-1146
Phone (503) 517-8663

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
I20230706001793 OR Practitioner - Clinical Social Worker 3678932860 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Multnomah County Current Accepting new patients
Western Psychological and Counseling Services LLC CurrentSince May 24, 2023 Accepting new patients
Western Psychological and Counseling Services LLC Clinical CurrentSince May 24, 2023 Accepting new patients
Multnomah County CurrentSince Jul 25, 2023 Accepting new patients
Multnomah County CurrentSince Jul 25, 2023 Accepting new patients
Catholic Community Services of Western Washington Past Accepting new patients

Locations

880 82nd Dr
Gladstone, OR 97027
Phone (503) 626-9494

600 NE 8th St
Gresham, OR 97030
Phone (503) 988-4900

8280 NE Mauzey Ct
Hillsboro, OR 97124
Phone (503) 439-9531

209 SW 4th Ave
Ste 210
Portland, OR 97204
Phone (503) 988-3674

619 NW 6th Ave
Fl 5
Portland, OR 97209
Phone (503) 988-5558

Organizations & group practices 6

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": "1435190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676246400000",
    "number": "1750763728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1904 SE DIVISION ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972021146",
            "telephone_number": "503-517-8663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1904 SE DIVISION ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97202",
            "telephone_number": "503-517-8663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMBERLAIN",
        "first_name": "HAILEY",
        "middle_name": "ELISABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-25",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L11160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.