Individual provider Active NPI

Liberty Karp, LCSW

  • Clinical Social Worker
  • Portland, OR
National Provider Identifier
1962924290
Registry record updated May 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L7143 Issued in OR
Practice address
4410 SE 45TH Ave
Portland, OR 97206-4012
Phone
(503) 939-4788
NPI assigned
Jul 7, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2024

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 L7143 OR Primary

Addresses

Primary practice location

4410 SE 45TH Ave
Portland, OR 97206-4012

Mailing address

4410 SE 45TH Ave
Portland, OR 97206-4012
Phone (503) 939-4788

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
I20170926004123 OR Practitioner - Clinical Social Worker 7315211554 Practice locations: Portland, OR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4410 SE 45TH Ave
Portland, OR 97206-4012
Phone (503) 939-4788

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L7143ORMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Rooted PDX LLC Clinical CurrentSince Aug 17, 2019 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": "1499385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716681600000",
    "number": "1962924290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4410 SE 45TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972064012",
            "telephone_number": "503-939-4788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4410 SE 45TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972064012",
            "telephone_number": "503-939-4788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARP",
        "first_name": "LIBERTY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-07",
        "last_updated": "2024-05-26",
        "certification_date": "2024-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L7143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.