Individual provider Active NPI

Lori Kay Cunnington Elam, LCSW

  • Clinical Social Worker
  • Eugene, OR
National Provider Identifier
1811011992
Registry record updated Mar 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L4837 Issued in OR
Practice address
1355 W 13TH Ave
Eugene, OR 97402-3955
Phone
(541) 206-2718
Fax
(541) 606-3607
NPI assigned
Mar 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2014

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 L4837 OR Primary

Addresses

Primary practice location

1355 W 13TH Ave
Eugene, OR 97402-3955

Mailing address

PO Box 1045
Veneta, OR 97487-1045
Phone (541) 206-2718

Other identifiers 1

IdentifierTypeStateIssuer
L4837OtherOROREGON STATE BOARD OF LICENSED SOCIAL WORKERS

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
L4837ORMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395100800000",
    "number": "1811011992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1045",
            "city": "VENETA",
            "state": "OR",
            "postal_code": "974871045",
            "telephone_number": "541-206-2718",
            "fax_number": "541-636-3607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 W 13TH AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974023955",
            "telephone_number": "541-206-2718",
            "fax_number": "541-606-3607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGTON ELAM",
        "first_name": "LORI",
        "middle_name": "KAY",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-16",
        "last_updated": "2014-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L4837",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OREGON STATE BOARD OF LICENSED SOCIAL WORKERS",
            "identifier": "L4837",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2014; 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.