Active NPI
Susan Marie Wolfer, LCSW
- Social Worker
- Portland, OR
National Provider Identifier
1922274307
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 3583
- Practice address
- 12132 SE Foster PL
Portland, OR 97266-4983 - Phone
- (503) 762-7612
- Fax
- (775) 628-9196
- NPI assigned
- May 5, 2008
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 3583 | OR | Primary |
Addresses
Primary practice location
12132 SE Foster PL
Portland, OR 97266-4983
Mailing address
12132 SE Foster PL
Portland, OR 97266-4983
Phone (503) 762-7612
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090211000497 | OR | Practitioner - Clinical Social Worker | 8022173855 | Practice locations: Portland, OR |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3583 | OR | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209945600000",
"number": "1922274307",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12132 SE FOSTER PL",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972664983",
"telephone_number": "503-762-7612",
"fax_number": "775-628-9196"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12132 SE FOSTER PL",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972664983",
"telephone_number": "503-762-7612",
"fax_number": "775-628-9196"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLFER",
"first_name": "SUSAN",
"middle_name": "MARIE",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-05-05",
"last_updated": "2008-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OR",
"license": "3583",
"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 May 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.