Individual provider Active NPI

Elizabeth Jane Clemens Hjorth, LCSW

  • Clinical Social Worker
  • Bend, OR
National Provider Identifier
1972360113
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L10876 Issued in OR
Practice address
2755 NE 27TH St
Bend, OR 97701-9539
Phone
(541) 383-3005
Fax
(541) 383-1883
NPI assigned
Mar 4, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 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 L10876 OR Primary

Addresses

Primary practice location

2755 NE 27TH St
Bend, OR 97701-9539

Mailing address

PO Box 4228
Portland, OR 97208-4228
Phone (541) 383-3005

Other names 1

  • Elizabeth Jane Clemens Other name

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
I20240418002177 OR Practitioner - Clinical Social Worker 2062851496 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mosaic Community Health CurrentSince May 6, 2024 Accepting new patients
Mosaic Community Health CurrentSince Mar 12, 2024 Accepting new patients

Locations

2755 NE 27th St
Bend, OR 97701

2084 NE Professional Ct
Bend, OR 97701
Phone (541) 322-5753

375 NW Beaver St
Ste 101
Prineville, OR 97754
Phone (541) 316-6026

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": "1709510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1972360113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4228",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972084228",
            "telephone_number": "541-383-3005",
            "fax_number": "541-383-1883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2755 NE 27TH ST",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977019539",
            "telephone_number": "541-383-3005",
            "fax_number": "541-383-1883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HJORTH",
        "first_name": "ELIZABETH",
        "middle_name": "JANE CLEMENS",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-04",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L10876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "CLEMENS",
            "middle_name": "JANE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.