Individual provider Active NPI

Tania Welikala, LCSW

  • Clinical Social Worker
  • Roseburg, OR
National Provider Identifier
1942616537
Registry record updated Jun 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L7278 Issued in OR
Practice address
1652 NW Hughwood CT
Roseburg, OR 97471-8844
Phone
(541) 673-3985
NPI assigned
Jul 3, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2017

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 L7278 OR Primary

Addresses

Primary practice location

1652 NW Hughwood CT
Roseburg, OR 97471-8844

Mailing address

1652 NW Hughwood CT
Roseburg, OR 97471-8844
Phone (541) 673-3985

Other identifiers 1

IdentifierTypeStateIssuer
500693287MedicaidOR

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
I20171030003324 OR Practitioner - Clinical Social Worker 0143596502

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1404345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496966400000",
    "number": "1942616537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1652 NW HUGHWOOD CT",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974718844",
            "telephone_number": "541-673-3985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1652 NW HUGHWOOD CT",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974718844",
            "telephone_number": "541-673-3985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELIKALA",
        "first_name": "TANIA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-03",
        "last_updated": "2017-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L7278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500693287",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseburg, OR

Sources for this page

Verify at the official NPI Registry.