Individual provider Active NPI

Tara Christina Sheldon, LCSW, CADC I

  • Clinical Social Worker
  • McMinnville, OR
National Provider Identifier
1801181359
Registry record updated Feb 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L7932 Issued in OR
Practice address
627 NE Evans St
McMinnville, OR 97128-3923
Phone
(503) 434-7523
NPI assigned
Jun 13, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X L7932 OR Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 17-04-16 OR

Addresses

Primary practice location

627 NE Evans St
McMinnville, OR 97128-3923

Mailing address

627 NE Evans St
McMinnville, OR 97128-3923
Phone (503) 434-7523

Other identifiers 1

IdentifierTypeStateIssuer
1883825MedicaidMI

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

NPI Registry JSON

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

{
    "created_epoch": "1307923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582675200000",
    "number": "1801181359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "627 NE EVANS ST",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971283923",
            "telephone_number": "503-434-7523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "627 NE EVANS ST",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971283923",
            "telephone_number": "503-434-7523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELDON",
        "first_name": "TARA",
        "middle_name": "CHRISTINA",
        "credential": "LCSW, CADC I",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-13",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L7932",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "17-04-16",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1883825",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McMinnville, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2020; 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.