Individual provider Active NPI

Emily Katherine Sladicka

  • Clinical Social Worker
  • Portland, OR
National Provider Identifier
1801330634
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
12632358-3501 Issued in UT
Practice address
200 SW Market St
Portland, OR 97201-5715
Phone
(385) 502-3828
NPI assigned
Dec 13, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X TPSW4416 FL
Clinical Social Worker 1041C0700X C017543 NC
Clinical Social Worker 1041C0700X 12632358-3501 UT Primary

Addresses

Primary practice location

200 SW Market St
Portland, OR 97201-5715

Mailing address

10723 S Grandville Ave Unit 2204
South Jordan, UT 84009-1861
Phone (385) 502-3828

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

LicenseStateTypeSpecialty
TPSW4416FLMDClinical Social Worker
C017543NCMDClinical Social Worker
12632358-3501UTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1481587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1801330634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10723 S GRANDVILLE AVE UNIT 2204",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840091861",
            "telephone_number": "385-502-3828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SW MARKET ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972015715",
            "telephone_number": "385-502-3828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLADICKA",
        "first_name": "EMILY",
        "middle_name": "KATHERINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-13",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "TPSW4416",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C017543",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "12632358-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2025; 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.