Jerome M Sloan II, LCSW/CADC III//QMHP

Primary specialty

Social WorkerTaxonomy code 104100000X

License

L10965 Issued in OR

Practice address

1110 SE Alder St.
Suite 301 PMB #51
Portland, OR 97214

Phone

(541) 212-7089

NPI assigned

Jul 11, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Jerome M Massad Former name

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1499731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1871015941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5606 N WILLIAMS AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972172455",
            "telephone_number": "541-212-7089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 SE ALDER ST.",
            "address_2": "SUITE 301 PMB #51",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97214",
            "telephone_number": "541-212-7089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLOAN II",
        "first_name": "JEROME",
        "middle_name": "M",
        "credential": "LCSW/CADC III//QMHP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-11",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OR",
            "license": "L10965",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "21-06-30017",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEROME",
            "last_name": "MASSAD",
            "middle_name": "M",
            "credential": "CADC III/CSWA/QMHP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Patrick Harold Sliger Sr.
• Rachel Sliger, LPC-A
• Allison Knight Sligh
• Jessica Slim, M.D., M.P.H.
• Laura Sliwoski, RD
• Lisa Sloan Strom, LPC, LLC
• Alexia Honore Sloan, LAC
• Erin Sloan, RN
• Forrest Israel James Sloan
• Heather L Sloan, RN, SANE

• Social Worker in Portland, OR
• Providers in Portland, OR by specialty
• Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.