Individual provider Active NPI

Penny J McAvoy, LCSW

  • Clinical Social Worker
  • Eugene, OR
National Provider Identifier
1770619207
Registry record updated Feb 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L912SR Issued in OR
Practice address
2650 Suzanne Way
Suite 120
Eugene, OR 97408-7619
Phone
(541) 345-2800
Fax
(541) 345-4419
NPI assigned
Feb 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2017

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 L912SR OR Primary

Addresses

Primary practice location

2650 Suzanne Way
Suite 120
Eugene, OR 97408-7619

Mailing address

2650 Suzanne Way
Ste 120
Eugene, OR 97408-7619
Phone (541) 345-2800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L912SRORMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Willamette Community Health Solutions Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486339200000",
    "number": "1770619207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 SUZANNE WAY",
            "address_2": "STE 120",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974087619",
            "telephone_number": "541-345-2800",
            "fax_number": "541-345-4419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 SUZANNE WAY",
            "address_2": "SUITE 120",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974087619",
            "telephone_number": "541-345-2800",
            "fax_number": "541-345-4419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCAVOY",
        "first_name": "PENNY",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2017-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L912SR",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2017; 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.