Active NPI
Sarah E Bruno, LCSW
- Clinical Social Worker
- Portland, OR
National Provider Identifier
1992205223
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- L8384
- Practice address
- 12360 E Burnside St
Portland, OR 97233-1042 - Phone
- (971) 279-4800
- Fax
- (971) 279-2051
- NPI assigned
- Feb 13, 2018
- 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 | L8384 | OR | Primary |
Addresses
Primary practice location
12360 E Burnside St
Portland, OR 97233-1042
Mailing address
1776 SW Madison St
Portland, OR 97205-1715
Phone (503) 224-1044
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500759575 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1518480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600905600000",
"number": "1992205223",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1776 SW MADISON ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972051715",
"telephone_number": "503-224-1044",
"fax_number": "503-621-2235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12360 E BURNSIDE ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972331042",
"telephone_number": "971-279-4800",
"fax_number": "971-279-2051"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUNO",
"first_name": "SARAH",
"middle_name": "E",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-13",
"last_updated": "2020-09-24",
"certification_date": "2020-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OR",
"license": "L8384",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500759575",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.