NPI 1801290408 · live from the CMS NPI Registry
Miranda Tai Campbell Acharya, LCSW
Social Worker, Clinical in Portland, OR. National Provider Identifier 1801290408, active.
NPI record
| NPI | 1801290408 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Social Worker, Clinical 1041C0700X |
| Practice location | 6906 N Richards St, Portland, OR 97203 |
| Practice phone | 971-266-1081 |
| Mailing address | 1622 Ne Couch St, Portland, OR 97232 |
| Enumerated | October 10, 2014 |
| Last updated | December 11, 2020 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | — |
| Social Worker, Clinical primary | 1041C0700X | L8514 (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.