Organization Active NPI

Brave Acorn

Doing business as Brave Acorn Counseling

  • Clinical Social Worker
  • Portland, OR
National Provider Identifier
1760971824
Registry record updated Aug 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4301 Issued in OR
Legal business name
BRAVE ACORN
Doing business as
Brave Acorn Counseling
Practice address
1675 SW Marlow Ave
Suite 303
Portland, OR 97225
Phone
(503) 709-5137
Fax
(503) 200-1198
NPI assigned
May 4, 2018
Last updated
Aug 18, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2020

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

Authorized official

Name
Sarah C Alexander, LCSWNPI 1932340726
Title
Owner
Phone
(503) 709-5137

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 4301 OR Primary

Addresses

Primary practice location

1675 SW Marlow Ave
Suite 303
Portland, OR 97225

Mailing address

1675 SW Marlow Ave Ste 303
Portland, OR 97225-5102
Phone (503) 709-5137

Other identifiers 1

IdentifierTypeStateIssuer
26-4409846MedicaidOR

Other names 1

  • Brave Acorn Counseling Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200825000156 OR Part B Supplier - Clinic/Group Practice 8426475393 Receives reassigned benefits from 1 practitioner
Practice locations: Portland, OR

National Provider Directory

National Provider Directory

Locations

2512 SE 25th Ave
Ste 305
Portland, OR 97202
Phone (503) 709-5137

Practitioners & affiliated clinicians

Practitioners 3

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": "1525392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597708800000",
    "number": "1760971824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 SW MARLOW AVE STE 303",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255102",
            "telephone_number": "503-709-5137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 SW MARLOW AVE",
            "address_2": "SUITE 303",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97225",
            "telephone_number": "503-709-5137",
            "fax_number": "503-200-1198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAVE ACORN",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-04",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A",
        "authorized_official_last_name": "ALEXANDER",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-709-5137",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "4301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "26-4409846",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brave Acorn Counseling",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Brave Acorn Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.