Individual provider Active NPI

Cynthia Ann McQuade, LCSW

  • Clinical Social Worker
  • Corvallis, OR
National Provider Identifier
1922245216
Registry record updated Mar 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L6125 Issued in OR
Practice address
2075 NW Grant Ave
Corvallis, OR 97330
Phone
(541) 368-3152
Fax
(855) 279-0612
NPI assigned
Jan 8, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2019

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 L6125 OR Primary

Addresses

Primary practice location

2075 NW Grant Ave
Corvallis, OR 97330

Mailing address

2075 NW Grant Ave
Corvallis, OR 97330-4366
Phone (541) 368-3152

Other practice location 1

182 SW Academy St Ste 333
Dallas, OR 97338-1922
Phone (503) 623-9289

Other names 1

  • Cynthia Ann Johnson-Rose Former name

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
I20141229002170 OR Practitioner - Clinical Social Worker 8123341005 Practice locations: Tidewater, OR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

584 E Buck Creek Rd
Tidewater, OR 97390-9629
Phone (541) 528-4125

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L6125ORMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Developing Hope Clinical 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.

NPI Registry JSON

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

{
    "created_epoch": "1231372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553731200000",
    "number": "1922245216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2075 NW GRANT AVE",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973304366",
            "telephone_number": "541-368-3152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2075 NW GRANT AVE",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "97330",
            "telephone_number": "541-368-3152",
            "fax_number": "855-279-0612"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "182 SW Academy St Ste 333",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "OR",
            "postal_code": "973381922",
            "country_code": "US",
            "telephone_number": "503-623-9289",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCQUADE",
        "first_name": "CYNTHIA",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-08",
        "last_updated": "2019-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L6125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CYNTHIA",
            "last_name": "JOHNSON-ROSE",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Corvallis, OR

Sources for this page

Verify at the official NPI Registry.