Individual provider Active NPI

Sean Stewart

  • Clinical Social Worker
  • Eugene, OR
National Provider Identifier
1851674295
Registry record updated Sep 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L12655 Issued in OR
Practice address
2145 Centennial PLZ
Eugene, OR 97401-2474
Phone
(541) 984-3105
NPI assigned
Sep 22, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2021

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
Clinical Social Worker 1041C0700X L12655 OR Primary

Addresses

Primary practice location

2145 Centennial PLZ
Eugene, OR 97401-2474

Mailing address

15 Horseblock PL
Farmingville, NY 11738-1204

Other practice location 1

15 Horseblock Pl
Farmingville, NY 11738-1204
Phone (631) 854-2571

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

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": "1316649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1851674295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 HORSEBLOCK PL",
            "city": "FARMINGVILLE",
            "state": "NY",
            "postal_code": "117381204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2145 CENTENNIAL PLZ",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012474",
            "telephone_number": "541-984-3105"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 Horseblock Pl",
            "address_purpose": "LOCATION",
            "city": "Farmingville",
            "state": "NY",
            "postal_code": "117381204",
            "country_code": "US",
            "telephone_number": "631-854-2571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEWART",
        "first_name": "SEAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-22",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L12655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

Verify at the official NPI Registry.