Active NPI
Janice M Bergman, LCSW
- Clinical Social Worker
- Lake Oswego, OR
National Provider Identifier
1992967525
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW1156
- Practice address
- 15100 Boones Ferry Rd
Suite 700a
Lake Oswego, OR 97035-3469 - Phone
- (503) 636-2877
- Fax
- (503) 635-9127
- NPI assigned
- Jun 25, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 | LCSW1156 | OR | Primary |
Addresses
Primary practice location
15100 Boones Ferry Rd
Suite 700a
Lake Oswego, OR 97035-3469
Mailing address
15100 Boones Ferry Rd
Suite 700a
Lake Oswego, OR 97035-3469
Phone (503) 636-2877
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1156 | Other | OR | LCSW |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW1156 | OR | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214352000000",
"number": "1992967525",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15100 BOONES FERRY RD",
"address_2": "SUITE 700A",
"city": "LAKE OSWEGO",
"state": "OR",
"postal_code": "970353469",
"telephone_number": "503-636-2877",
"fax_number": "503-635-9127"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15100 BOONES FERRY RD",
"address_2": "SUITE 700A",
"city": "LAKE OSWEGO",
"state": "OR",
"postal_code": "970353469",
"telephone_number": "503-636-2877",
"fax_number": "503-635-9127"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERGMAN",
"first_name": "JANICE",
"middle_name": "M",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-06-25",
"last_updated": "2008-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OR",
"license": "LCSW1156",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LCSW",
"identifier": "1156",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lake Oswego, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.