Active NPI
Christina Polizzo, MSW, LCSW.
- Clinical Social Worker
- Corvallis, OR
National Provider Identifier
1851854780
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 44SC04780400
- Practice address
- 277 NE Conifer Blvd Unit 46
Corvallis, OR 97330-4141 - Phone
- (908) 256-5574
- NPI assigned
- Apr 8, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 | 44SC04780400 | NJ | Primary |
Addresses
Primary practice location
277 NE Conifer Blvd Unit 46
Corvallis, OR 97330-4141
Mailing address
277 NE Conifer Blvd Unit 46
Corvallis, OR 97330-4141
Phone (908) 256-5574
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CSW09925607 | Other | CO | LICENSE |
| 44SC04780400 | Other | NJ | LICENSE |
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 |
|---|---|---|---|
| 44SC04780400 | NJ | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554681600000",
"number": "1851854780",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "277 NE CONIFER BLVD UNIT 46",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973304141",
"telephone_number": "908-256-5574"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "277 NE CONIFER BLVD UNIT 46",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973304141",
"telephone_number": "908-256-5574"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLIZZO",
"first_name": "CHRISTINA",
"credential": "MSW, LCSW.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-04-08",
"last_updated": "2019-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NJ",
"license": "44SC04780400",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "CSW09925607",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "44SC04780400",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Corvallis, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.