Individual provider Active NPI

Lina Soares, LCSW, MSW

  • Clinical Social Worker
  • Corvallis, OR
National Provider Identifier
1780211359
Registry record updated May 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L8051 Issued in OR
Practice address
636 SW 2ND St
Corvallis, OR 97333-4442
Phone
(541) 230-8497
Fax
(541) 600-3330
NPI assigned
Mar 24, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2021

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 L8051 OR Primary

Addresses

Primary practice location

636 SW 2ND St
Corvallis, OR 97333-4442

Mailing address

1923 SW Brooklane Dr
Corvallis, OR 97333-1627
Phone (541) 230-8497

Other practice location 1

1923 SW Brooklane Dr
Corvallis, OR 97333-1627
Phone (541) 230-8497

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
I20201019002225 OR Practitioner - Clinical Social Worker 9830519529 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1923 SW Brooklane Dr
Corvallis, OR 97333-1627
Phone (541) 230-8497

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lina Soares, LCSW, LLC Clinical CurrentSince Aug 20, 2020 Accepting new patients

Locations

636 SW 2nd St
Corvallis, OR 97333
Phone (541) 231-1277

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": "1585008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620259200000",
    "number": "1780211359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1923 SW BROOKLANE DR",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973331627",
            "telephone_number": "541-230-8497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 SW 2ND ST",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973334442",
            "telephone_number": "541-230-8497",
            "fax_number": "541-600-3330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1923 SW Brooklane Dr",
            "address_purpose": "LOCATION",
            "city": "Corvallis",
            "state": "OR",
            "postal_code": "973331627",
            "country_code": "US",
            "telephone_number": "541-230-8497",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOARES",
        "first_name": "LINA",
        "credential": "LCSW, MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-24",
        "last_updated": "2021-05-06",
        "certification_date": "2021-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L8051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

Verify at the official NPI Registry.