PETER SHAPOVAL (NPI# 1093111437) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093111437 |
| Entity Type | Individual |
| Full Name | PETER SHAPOVAL |
| Practice Address |
4545 Se Ina Ave Apt 9 Milwaukie OR 97267-5918 |
| Mailing Address |
3587 Heathrow Way Medford OR 97504-4004 |
| Practice Telephone | 5036545678 |
| Practice Fax Number | 5036541236 |
| Mailing Telephone | 5418588170 |
| Mailing Fax Number | 5418588167 |
| Enumeration Date | 2014-11-12 |
| Last Update Date | 2014-11-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers |
| Street Address |
4545 SE INA AVE APT 9 |
| City | MILWAUKIE |
| State | OR |
| Zip Code | 97267-5918 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912303355 | Mikaela Shrumm | Counselor | 4545 Se Ina Ave Apt 9, Milwaukie, OR 97267-5918 | 2014-11-12 |
| 1083138457 | Eris Egan | Counselor | 4545 Se Ina Ave Apt 9, Milwaukie, OR 97267-5918 | 2017-07-27 |
| 1083155071 | Ben Gernert | Counselor | 4545 Se Ina Ave Apt 9, Milwaukie, OR 97267-5918 | 2017-03-10 |
| 1457894933 | Tina Fritsche | Counselor | 4545 Se Ina Ave Apt 9, Milwaukie, OR 97267-5918 | 2016-12-01 |
| 1700331212 | Justin Reynolds | Counselor | 4545 Se Ina Ave Apt 9, Milwaukie, OR 97267-5918 | 2016-08-25 |
| 1790230373 | Kiersten Simmons | Counselor | 4545 Se Ina Ave Apt 9, Milwaukie, OR 97267-5918 | 2016-08-24 |
| 1790144103 | Izarra Varela | Counselor | 4545 Se Ina Ave Apt 9, Milwaukie, OR 97267-5918 | 2016-02-12 |
| 1164888467 | Alison Noe | Counselor | 4545 Se Ina Ave Apt 9, Milwaukie, OR 97267-5918 | 2016-01-04 |
| 1295106276 | Harold Eberhart | Counselor | 4545 Se Ina Ave Apt 9, Milwaukie, OR 97267-5918 | 2015-10-15 |
| 1366831265 | Jessica Hart | Social Worker | 4545 Se Ina Ave Apt 9, Milwaukie, OR 97267-5918 | 2015-01-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851911036 | Michelle Renee Gilham | Massage Therapist | 16560 S.e. 80th Ave, Portland Or 97267, 19650 Se 80th Ave, Portland, OR 97267 | 2020-04-17 |
| 1629557442 | Benchmark Physical Therapy of Or, LLC | Occupational Therapist | 14874 Se Webster Rd, Milwaukie, OR 97267 | 2018-08-13 |
| 1326541764 | Theresa Elaine Day | Massage Therapist | 2080 Se Oak Grove Blvd Ste 16, Portland, OR 97267 | 2018-03-12 |
| 1881015378 | Kathryn Louise Engstrom | Registered Nurse | 6901 Se Lake Road, Portland, OR 97267 | 2013-12-30 |
| 1285951293 | Eliza Ann Rowley | Acupuncturist | 2080 Se Oak Grove Blvd #9, Milwaukie, OR 97267 | 2010-04-29 |
| 1346438124 | Rx Direct Inc | Pharmacy | 16246 Se Mcloughlin, Milwaukie, OR 97267 | 2007-10-05 |
| 1477740827 | Olson Drug, Inc | Durable Medical Equipment & Medical Supplies | 16244 Se Mcloughlin Blvd, Milwaukie, OR 97267 | 2007-10-01 |
| 1831308451 | Jeannie Marie Baer | Massage Therapist | 16705 Se Mcloughlin, Milwaukie, OR 97267 | 2007-05-21 |
| 1902923667 | Matthew William Krueger | Specialist/Technologist | 4950 Se Roethe Rd., Milwaukie, OR 97267 | 2007-03-26 |
| 1316084049 | Renee' Lorena Raschke | Counselor | 17070se Mcloughlin Blvd., Milwaukie, OR 97267 | 2007-01-31 |
| Find all providers in zip 97267 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740887249 | Bethany Anne Harvey | Social Worker | 14020 Se Briggs St, Milwaukie, OR 97267-1503 | 2020-10-07 |
| 1164049417 | Yvonne Marie Smith | Social Worker | 12530 Se Shell Ln, Milwaukie, OR 97222-8805 | 2020-07-02 |
| 1306319918 | Mary Cosentino-cathey | Social Worker | 11376 Se Linwood Ave, Milwaukie, OR 97222-2749 | 2019-01-07 |
| 1336617448 | Nadia Yang | Social Worker | 2115 Se Adams St, Milwaukie, OR 97222 | 2018-11-06 |
| 1891000782 | Rachael A Ringwood | Social Worker | 2029 Se Jefferson St Ste 107, Milwaukie, OR 97222-7605 | 2010-08-16 |
| 1447425699 | Amy Leann Pfunder | Social Worker | 17070 Se Pine Cone Ln, Milwaukie, OR 97267-5609 | 2008-04-29 |
| 1679759369 | Richard Gordon | Social Worker | 12439 Se 26th Avenue, Milwaukie, OR 97222-8705 | 2008-01-14 |
| 1750447702 | Eileen Masover | Social Worker | 2816 Se Harrison St, Ste 305, Milwaukie, OR 97222-7536 | 2006-12-27 |
| 1992860803 | Justin C O'hanlon | Social Worker | 2100 Se Lake Rd, #2a, Milwaukie, OR 97222-7759 | 2006-12-22 |
| 1801423876 | Judy Marie Schumacker | Social Worker | 10150 Se 32nd Ave, Milwaukie, OR 97222-6516 | 2020-03-26 |
| Find all providers in MILWAUKIE | ||||
Please comment or provide details below to improve the information on PETER SHAPOVAL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.