Individual provider Active NPI

Emily Louise Millhollen, LCSW

  • Clinical Social Worker
  • Springfield, OR
National Provider Identifier
1912169889
Registry record updated Jul 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L7206 Issued in OR
Practice address
1902 Harbor Drive
Springfield, OR 97477
Phone
(541) 600-4744
Fax
(541) 615-1477
NPI assigned
Jul 1, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X L7206 OR Primary

Addresses

Primary practice location

1902 Harbor Drive
Springfield, OR 97477

Mailing address

PO Box 1320
Springfield, OR 97477-0152
Phone (541) 600-4744

Other identifiers 1

IdentifierTypeStateIssuer
019047MedicaidOR

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20170202002070 OR Practitioner - Clinical Social Worker 0749563435 Practice locations: Springfield, OR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

747 F St
Springfield, OR 97477-4040
Phone (541) 600-4744

PO Box
Suite 1320
Springfield, OR 97477-0152

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": "1214870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1912169889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1320",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974770152",
            "telephone_number": "541-600-4744",
            "fax_number": "541-615-1477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1902 HARBOR DRIVE",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "97477",
            "telephone_number": "541-600-4744",
            "fax_number": "541-615-1477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLHOLLEN",
        "first_name": "EMILY",
        "middle_name": "LOUISE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-01",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L7206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019047",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OR

Sources for this page

Verify at the official NPI Registry.