Active NPI
Caz H Novak, LCSW
- Clinical Social Worker
- Gresham, OR
National Provider Identifier
1790390466
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- L11785
- Practice address
- 620 NE 2ND St
Gresham, OR 97030-7514 - Phone
- (971) 274-3757
- Fax
- (503) 912-5740
- NPI assigned
- Sep 10, 2020
- Last updated
- Jul 18, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | L11785 | OR | Primary |
Addresses
Primary practice location
620 NE 2ND St
Gresham, OR 97030-7514
Mailing address
1776 SW Madison St
Portland, OR 97205-1715
Phone (503) 224-1044
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500812565 | Medicaid | OR |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L11785 | OR | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721260800000",
"number": "1790390466",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1776 SW MADISON ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972051715",
"telephone_number": "503-224-1044",
"fax_number": "503-621-2235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 NE 2ND ST",
"city": "GRESHAM",
"state": "OR",
"postal_code": "970307514",
"telephone_number": "971-274-3757",
"fax_number": "503-912-5740"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOVAK",
"first_name": "CAZ",
"middle_name": "H",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-09-10",
"last_updated": "2024-07-18",
"certification_date": "2024-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OR",
"license": "L11785",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500812565",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gresham, OR
- Scout Northway, MA
- Northwest Extremity Specialists
- Northwest Oral & Maxillofacial Surgeons, LLC
- Northwest Oral and Maxillofacial Surgeons (Beacon Oral and Maxillofacial Surgeons)
- Northwest Serenity LLC
- NS Hearing Network (Willoughby Hearing)
- Rachael Null, ND, LAC
- Kathryn Mae Nunley, QMHP
- Nurture Family Health, LLC
- Jesse Layne Nuttall, D.C.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.