ANDRE B PRUITT PH.D., MSW
NPI 1205988532
Social Worker - Clinical in Portland, OR

Q: What is Andre Pruitt's NPI number?

The NPI number for Andre Pruitt is 1205988532. It was assigned to this individual provider in the NPPES registry on January 17, 2007.

Q: What is Andre Pruitt's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Andre Pruitt was last updated on June 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.

Active since January 17, 2007PECOS Enrolled

1220 SW MORRISON ST STE 730, PORTLAND, OR 97205(503) 860-1213(503) 988-3676 Get Directions Write a Review

NPPES record last updated: June 20, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 20, 2024, Jun 17, 2016 (2 updates tracked since 2016).

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About Andre B Pruitt Ph.d., Msw NPPES

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

ANDRE B PRUITT PH.D., MSW (NPI 1205988532) is an individual clinical provider in Portland, Oregon, licensed in Oregon (3529) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1205988532

Entity TypeIndividualMale

Primary Taxonomy1041C0700X

Provider Legal NameANDRE B PRUITTCredential: PH.D., MSW

Location Address1220 SW MORRISON ST STE 730Portland, OR 97205-2226

Mailing Address6926 Ne 22nd AvePortland, OR 97211-5245 · (503) 860-1213 · Fax (844) 889-4937

Phone(503) 860-1213

Fax(503) 988-3676

Sole ProprietorNo

Enumeration DateJanuary 17, 2007

Last NPPES UpdateJune 20, 20242 updates tracked since enumeration

NPPES CertifiedJune 20, 2024

✔ NPI 1205988532 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 · 3529

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.

1220 SW MORRISON ST STE 730, Portland, OR 97205

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., PacificSource Health Plans.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Andre B Pruitt Ph.d., Msw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97205 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$0.00 typical visit price

range $58.99 – $176.88

Typical copayment $0.00 (range $14.74 – $44.22)

Most-billed visit code NA

Established Patient

$73.28 typical visit price

range $19.32 – $144.79

Typical copayment $18.32 (range $4.83 – $36.19)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

DR. JEFFERY WISE PMHNP-BC

Nurse Practitioner (Psychiatric/Mental Health)