SUNDANCE COUNSELING WEST LLC – Clinical Social Worker, NPI 1285260471
Clinical Social Worker
Main info
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Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for SUNDANCE COUNSELING WEST LLC
17218 S RAMSBY RD
MOLALLA, OR 970387634
Phone: (503) 616-1101
Fax: (503) 334-4379
Type: Mailing
201 B AVE STE 295
LAKE OSWEGO, OR 970343290
Phone: (503) 616-1101
Fax: (503) 334-4379
Type: Location
1177 C AVE
LAKE OSWEGO, OR 970342103
Phone: (503) 310-8081
Fax: (503) 334-4379
Type: Mailing
20510 SW ROY ROGERS RD STE 150
SHERWOOD, OR 971409320
Phone: (503) 616-1101
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2020-12-24
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2026-02-28 (101 days ago).
Enrollment records
3
Earliest due date
2026-02-28
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20201209000474 | O | Clinic/Group Practice | CO | 2026-02-28 |
| O20201214002425 | O | Clinic/Group Practice | AZ | 2026-09-30 |
| O20201224000510 | O | Clinic/Group Practice | OR | 2026-10-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 97038)
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