Active NPI
Mialee Womack, LCSW
- Clinical Social Worker
- Corvallis, OR
National Provider Identifier
1922369578
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- L3743
- Practice address
- 3509 NW Samaritan Dr Ste 215
Corvallis, OR 97330-3893 - Phone
- (541) 768-5235
- NPI assigned
- May 30, 2012
- Sex
- Female
- Sole proprietor
- No
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 | L3743 | OR | Primary |
Addresses
Primary practice location
3509 NW Samaritan Dr Ste 215
Corvallis, OR 97330-3893
Mailing address
PO Box 1189
Corvallis, OR 97339-1189
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mwomack6799@samhealth.direct-ci.com |
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 |
|---|---|---|---|
| L3743 | OR | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Firstcare Medical Foundation | Past | Accepting new patients |
Interoperability endpoints
- mwomack6799@samhealth.direct-ci.com
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.
-
- Family Medicine Physician
- Albany, OR
- NPI 1740216498
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1338336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615766400000",
"number": "1922369578",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1189",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973391189"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3509 NW SAMARITAN DR STE 215",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973303893",
"telephone_number": "541-768-5235"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOMACK",
"first_name": "MIALEE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-05-30",
"last_updated": "2021-03-15",
"certification_date": "2021-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OR",
"license": "L3743",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mwomack6799@samhealth.direct-ci.com",
"affiliation": "N",
"address_1": "3509 NW Samaritan Dr Ste 215",
"city": "Corvallis",
"state": "OR",
"country_code": "US",
"postal_code": "973303893",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Corvallis, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.