Individual provider Active NPI

Alice Meree King, MSW, LCSW

  • Clinical Social Worker
  • Gresham, OR
National Provider Identifier
1891858890
Registry record updated Nov 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
4101 NE Division St Ste 100
Telecare Corp
Gresham, OR 97030-4617
Phone
(503) 666-3808
NPI assigned
Dec 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X RC00055592 WA
Social Worker 104100000X
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

4101 NE Division St Ste 100
Telecare Corp
Gresham, OR 97030-4617

Mailing address

4101 NE Division St Ste 100
Telecare Corp
Gresham, OR 97030-4617
Phone (503) 666-3808

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250605003764 OR Order and Referring Only - Clinical Social Worker 7012159478

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RC00055592WAMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478044800000",
    "number": "1891858890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 NE DIVISION ST STE 100",
            "address_2": "TELECARE CORP",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970304617",
            "telephone_number": "503-666-3808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 NE DIVISION ST STE 100",
            "address_2": "TELECARE CORP",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970304617",
            "telephone_number": "503-666-3808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "ALICE",
        "middle_name": "MEREE",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2016-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WA",
            "license": "RC00055592",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

Verify at the official NPI Registry.