Active NPI
Ellen H Weiland, L.C.S.W.
- Clinical Social Worker
- Medford, OR
National Provider Identifier
1922005693
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- L2150
- Practice address
- 132 W Main St
Medford, OR 97501-2746 - Phone
- (541) 326-8989
- NPI assigned
- Jul 7, 2005
- Reactivated
- Mar 29, 2006
- 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 | L2150 | OR | Primary |
Addresses
Primary practice location
132 W Main St
Medford, OR 97501-2746
Mailing address
PO Box 851
Phoenix, OR 97535-0851
Phone (541) 326-8989
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 99945 | Other | OR | JACKSON COUNTY MENTAL HEA |
| 858186000 | Other | OR | BC BS - L.C.S.W. |
| 181580 | Medicaid | OR | |
| 317191 | Other | OR | PBH |
| J6586 | Other | OR | PACIFIC SOURCE HEALTH PN |
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 |
|---|---|---|---|
| L2150 | OR | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1256083200000",
"number": "1922005693",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 851",
"city": "PHOENIX",
"state": "OR",
"postal_code": "975350851",
"telephone_number": "541-326-8989"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "132 W MAIN ST",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975012746",
"telephone_number": "541-326-8989"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEILAND",
"first_name": "ELLEN",
"middle_name": "H",
"name_prefix": "Mrs.",
"credential": "L.C.S.W.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-07-07",
"last_updated": "2009-10-21",
"deactivation_date": "2006-03-21",
"reactivation_date": "2006-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OR",
"license": "L2150",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "JACKSON COUNTY MENTAL HEA",
"identifier": "99945",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC BS - L.C.S.W.",
"identifier": "858186000",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "181580",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PBH",
"identifier": "317191",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PACIFIC SOURCE HEALTH PN",
"identifier": "J6586",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Medford, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.