Jennifer M Picanso-Sutton, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

LSW0000013867 Issued in TN

Practice address

2191 Marion St
North Bend, OR 97459-2314

Phone

(541) 378-7948

NPI assigned

Aug 24, 2022

Last updated

Sep 28, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1661299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1780303578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2569 EVERETT AVE",
            "city": "NORTH BEND",
            "state": "OR",
            "postal_code": "974592635",
            "telephone_number": "559-331-0003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2191 MARION ST",
            "city": "NORTH BEND",
            "state": "OR",
            "postal_code": "974592314",
            "telephone_number": "541-378-7948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICANSO-SUTTON",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-24",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TN",
            "license": "LSW0000013867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.myhealth.va.gov/mhv-portal-web/user-login",
            "affiliation": "N",
            "address_1": "913 NW Garden Valley Blvd",
            "city": "Roseburg",
            "state": "OR",
            "country_code": "US",
            "postal_code": "974716523",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Social Worker in North Bend, OR
• Providers in North Bend, OR by specialty
• Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2022; 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.