Active NPI
Elizabeth Jane Clemens Hjorth, LCSW
- Clinical Social Worker
- Bend, OR
National Provider Identifier
1972360113
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- L10876
- 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
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 | 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
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mosaic Community Health | Current | Accepting new patients | |
| Mosaic Community Health | Current | 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.
-
- Federally Qualified Health Center (FQHC)
- Prineville, OR
- NPI 1083633184
-
- Federally Qualified Health Center (FQHC)
- Bend, OR
- NPI 1275244345
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.