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CLEMENT NISBET WILSON FONSECA LCSW
NPI 1124539879
Social Worker - Clinical in Portland, OR

Active since October 21, 2017
3125B NE HOLLADAY ST, PORTLAND, OR 97232(503) 217-4457 Get Directions Write a Review

NPPES record last updated: September 2, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 2, 2025, Oct 21, 2017 (2 updates tracked since 2017).

About Clement Nisbet Wilson Fonseca Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CLEMENT NISBET WILSON FONSECA LCSW (NPI 1124539879) is an individual clinical provider in Portland, Oregon, licensed in Oregon (L11642) and active in the NPI registry since October 2017.

NPPES Registry Identity

NPI1124539879
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameCLEMENT NISBET WILSON FONSECACredential: LCSW
Location Address3125B NE HOLLADAY STPortland, OR 97232-2504
Mailing AddressPo Box 11764Portland, OR 97211-0764 · (857) 498-0287
Phone(503) 217-4457
Sole ProprietorYes
Enumeration DateOctober 21, 2017
Last NPPES UpdateSeptember 2, 20252 updates tracked since enumeration
NPPES CertifiedSeptember 2, 2025
✔ NPI 1124539879 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in OR · L11642
Definition
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.
3125B NE HOLLADAY ST, Portland, OR 97232
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Other Names 1

Former Name (1)Clementine M Wilson

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Regence BlueCross BlueShield of Oregon.Insurance ›

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HAYDEN LEINE COLLIER M.S.
Counselor (Mental Health)
3125B NE HOLLADAY ST
PORTLAND, OR 97232
Multnomah County (503) 966-8437
THE MINDFUL RDN, LLC
Dietitian, Registered
3125B NE HOLLADAY ST
PORTLAND, OR 97232
Multnomah County (971) 361-8250
ONLY HUMXN LLC
Counselor (Mental Health)
3125B NE HOLLADAY ST
PORTLAND, OR 97232
Multnomah County (503) 366-8437
AMBER WILSON CSWA
Counselor (Mental Health)
3125B NE HOLLADAY ST
PORTLAND, OR 97232
Multnomah County (503) 217-4457
BROOKE SEIBERT MS, RDN
Dietitian, Registered
3125B NE HOLLADAY ST
PORTLAND, OR 97232
Multnomah County (971) 361-8250

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Clement Fonseca's NPI number?

The NPI number for Clement Fonseca is 1124539879. It was assigned to this individual provider in the NPPES registry on October 21, 2017. The provider is also known as Clementine M Wilson.

Where is Clement Fonseca located?

Clement Fonseca practices at 3125B NE Holladay St, Portland, OR 97232. The listed phone number is (503) 217-4457.

What is Clement Fonseca's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

What insurance does Clement Fonseca accept?

Health plans from BridgeSpan Health Company and Regence BlueCross BlueShield of Oregon list Clement Fonseca as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Clement Fonseca was last updated on September 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.