Active NPI
Melissa J Woolsey, LCSW
- Clinical Social Worker
- Portland, OR
National Provider Identifier
1912018862
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 3876
- Practice address
- 3716 NE M L King Blvd
Portland, OR 97212-1111 - Phone
- (503) 288-8066
- Fax
- (503) 288-8168
- NPI assigned
- Aug 31, 2006
- Sex
- Female
- Sole proprietor
- No
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 | 3876 | OR | Primary |
Addresses
Primary practice location
3716 NE M L King Blvd
Portland, OR 97212-1111
Mailing address
3716 NE M L King Blvd
Portland, OR 97212-1111
Phone (503) 288-8066
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3876 | OR | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marion County | Past | Accepting new patients | |
| Marion County | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Methadone Clinic
- Salem, OR
- NPI 1386706919
-
- Adult Mental Health Clinic/Center
- Salem, OR
- NPI 1528147782
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1912018862",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3716 NE M L KING BLVD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972121111",
"telephone_number": "503-288-8066",
"fax_number": "503-288-8168"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3716 NE M L KING BLVD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972121111",
"telephone_number": "503-288-8066",
"fax_number": "503-288-8168"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOOLSEY",
"first_name": "MELISSA",
"middle_name": "J",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OR",
"license": "3876",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.