RUSTIC SAGE LLC
NPI 1861158610
Social Worker - Clinical in Portland, OR

Active since November 16, 2021
1220 SW MORRISON ST STE 730, PORTLAND, OR 97205(503) 860-1213(844) 889-4937 Get Directions Write a Review

NPPES record last updated: June 20, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 20, 2024, Jan 14, 2022, Nov 16, 2021 (3 updates tracked since 2021).

About Rustic Sage Llc NPPES

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

RUSTIC SAGE LLC (NPI 1861158610) is a healthcare organization registered as a clinical in Portland, Oregon and active in the NPI registry since November 2021. The organization lists Andre B Pruitt, Owner, as its authorized official.

NPPES Registry Identity

NPI1861158610
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NameRUSTIC SAGE LLC
Location Address1220 SW MORRISON ST STE 730Portland, OR 97205-2226
Mailing AddressPo Box 4162Portland, OR 97208-4162 · (503) 860-1213 · Fax (844) 889-4937
Fax(844) 889-4937
Organization SubpartNo
Authorized OfficialAndre B PruittOwner · (503) 860-1213
Enumeration DateNovember 16, 2021
Last NPPES UpdateJune 20, 20243 updates tracked since enumeration
NPPES CertifiedJune 20, 2024
NPI 1861158610 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
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

Other Names 1

Doing Business AsRustic Sage Llc

Other Identifiers 1

Medicaid500674262OR

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted 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.

Social Worker (Clinical)
1220 SW MORRISON ST STE 730
PORTLAND, OR 97205
Counselor (Mental Health)
1220 SW MORRISON ST STE 730
PORTLAND, OR 97205
Social Worker (Clinical)
1220 SW MORRISON ST STE 730
PORTLAND, OR 97205
Nurse Practitioner (Psychiatric/Mental Health)
1220 SW MORRISON ST STE 730
PORTLAND, OR 97205
Clinic/Center (Mental Health (Including Community Mental Health Center))
1220 SW MORRISON ST STE 730
PORTLAND, OR 97205

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 Rustic Sage LLC's NPI number?

The NPI number for Rustic Sage LLC is 1861158610. It was assigned to this organization in the NPPES registry on November 16, 2021.

Where is Rustic Sage LLC located?

Rustic Sage LLC is located at 1220 SW Morrison St Ste 730, Portland, OR 97205. The listed phone number is (503) 860-1213.

What is Rustic Sage LLC's specialty?

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

What insurance does Rustic Sage LLC accept?

Health plans from Moda Health Plan, Inc. list Rustic Sage LLC 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 Rustic Sage LLC was last updated on June 20, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.