Caroline Wolfe Bullard Resari, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L4321 Issued in OR

Practice address

3615 NE Grand Ave
Portland, OR 97212-2104

Phone

(503) 961-3141

Fax

(503) 281-0787

NPI assigned

Mar 8, 2010

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Nov 16, 2022 through Nov 16, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Owls Nest North Therapy Joint

  • Marriage & Family Therapist
  • Portland, OR
  • NPI 1376948232

  Clinical

  NPD (past)

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

{
    "created_epoch": "1268006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268006400000",
    "number": "1992028872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3615 NE GRAND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972122104",
            "telephone_number": "503-961-3141",
            "fax_number": "503-281-0787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3615 NE GRAND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972122104",
            "telephone_number": "503-961-3141",
            "fax_number": "503-281-0787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RESARI",
        "first_name": "CAROLINE",
        "middle_name": "WOLFE BULLARD",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-08",
        "last_updated": "2010-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L4321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Repp
• Sarah Reppenhagen, OTR/L
• Heather F Reppeto, QMHP-R
• Reproductive Medicine Laboratory
• Reprogenetics Oregon
• Sheila Resari, LMT
• Rescue Life Senior Care Agency
• Ryan Gregory Reseburg, PMHNP
• Juliette Resendez
• Joseph E Resendiz, D.O.

• Clinical Social Worker in Portland, OR
• Providers in Portland, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2010; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.