Individual provider Active NPI

Tamara Melissa Ulrey, LCSW

  • Clinical Social Worker
  • Grants Pass, OR
National Provider Identifier
1952605115
Registry record updated Oct 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L2560 Issued in OR
Practice address
980 SW 6TH St Ste 19a
Grants Pass, OR 97526-2910
Phone
(541) 476-7688
Fax
(541) 476-7688
NPI assigned
Jan 3, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2021

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 L2560 OR Primary

Addresses

Primary practice location

980 SW 6TH St Ste 19a
Grants Pass, OR 97526-2910

Mailing address

980 SW 6TH St Ste 19a
Grants Pass, OR 97526-2910
Phone (541) 476-7688

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
I20130604000521 OR Practitioner - Clinical Social Worker 3072751908 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

980 SW 6TH St
Suite 19a
Grants Pass, OR 97526-2910
Phone (541) 476-7688

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Eye to Eye Counseling and Therapy LLC CurrentSince Oct 26, 2021 Accepting new patients
County of Jackson CurrentSince Feb 20, 2013 Accepting new patients

Locations

980 SW 6th St
Ste 19A
Grants Pass, OR 97526
Phone (541) 476-7688

140 S Holly St
Medford, OR 97501
Phone (541) 774-8200

Organizations & group practices 2

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": "1294012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633478400000",
    "number": "1952605115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 SW 6TH ST STE 19A",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975262910",
            "telephone_number": "541-476-7688",
            "fax_number": "541-476-7688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 SW 6TH ST STE 19A",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975262910",
            "telephone_number": "541-476-7688",
            "fax_number": "541-476-7688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULREY",
        "first_name": "TAMARA",
        "middle_name": "MELISSA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-03",
        "last_updated": "2021-10-06",
        "certification_date": "2021-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L2560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grants Pass, OR

Sources for this page

Verify at the official NPI Registry.