Active NPI
Candis Kay Sollars, LCSW
- Clinical Social Worker
- Astoria, OR
National Provider Identifier
1922007434
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- L3219
- Practice address
- 1 12TH St
Suite #4
Astoria, OR 97103-4146 - Phone
- (503) 325-3623
- Fax
- (503) 325-4986
- NPI assigned
- Jul 18, 2005
- 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 | L3219 | OR | Primary |
Addresses
Primary practice location
1 12TH St
Suite #4
Astoria, OR 97103-4146
Mailing address
1 12TH St
Suite #4
Astoria, OR 97103-4146
Phone (503) 325-3623
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000000000053 | Other | OR | BLUE CROSS BLUE SHIELD |
| A023 | Other | OR | TRIWEST |
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 |
|---|---|---|---|
| L3219 | OR | MD | Clinical Social Worker |
| 3219 | OR | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Columbia Community Mental Health | Past | Accepting new patients |
Organizations & group practices 1
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.
-
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- Saint Helens, OR
- NPI 1861617359
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1299715200000",
"number": "1922007434",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 12TH ST",
"address_2": "SUITE #4",
"city": "ASTORIA",
"state": "OR",
"postal_code": "971034146",
"telephone_number": "503-325-3623",
"fax_number": "503-325-4986"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 12TH ST",
"address_2": "SUITE #4",
"city": "ASTORIA",
"state": "OR",
"postal_code": "971034146",
"telephone_number": "503-325-3623",
"fax_number": "503-325-4986"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOLLARS",
"first_name": "CANDIS",
"middle_name": "KAY",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-07-18",
"last_updated": "2011-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OR",
"license": "L3219",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "0000000000053",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRIWEST",
"identifier": "A023",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Astoria, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.