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THEODORE EVERETT LCSW
NPI 1508101445
Social Worker - Clinical in Portland, OR

Active since December 04, 2012PECOS Enrolled
2440 NE 11TH AVE, PORTLAND, OR 97212(503) 572-1349 Get Directions Write a Review

NPPES record last updated: October 20, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Oct 20, 2021, Feb 19, 2019, Jan 24, 2017 and 1 more (4 updates tracked since 2016).

About Theodore Everett Lcsw NPPES

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

THEODORE EVERETT LCSW (NPI 1508101445) is an individual clinical provider in Portland, Oregon, licensed in Oregon (L6777) and active in the NPI registry since December 2012. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1508101445
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameTHEODORE EVERETTCredential: LCSW
Location Address2440 NE 11TH AVEPortland, OR 97212-4127
Mailing Address2440 Ne 11th AvePortland, OR 97212-4127 · (646) 206-9824
Phone(503) 572-1349
Sole ProprietorYes
Enumeration DateDecember 4, 2012
Last NPPES UpdateOctober 20, 20214 updates tracked since enumeration
NPPES CertifiedOctober 19, 2021
✔ NPI 1508101445 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Licenses✔ Licensed in OR · L6777✔ Licensed in CA · 84551
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.
2440 NE 11TH AVE, Portland, OR 97212
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Theodore Everett Lcsw 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 97212 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.

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 Theodore Everett's NPI number?

The NPI number for Theodore Everett is 1508101445. It was assigned to this individual provider in the NPPES registry on December 4, 2012.

Where is Theodore Everett located?

Theodore Everett practices at 2440 NE 11th Ave, Portland, OR 97212. The listed phone number is (503) 572-1349.

What is Theodore Everett's specialty?

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

Is Theodore Everett enrolled in Medicare?

Yes. Theodore Everett is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Theodore Everett was last updated on October 20, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.