Create Change, LLC
NPI 1407210867 · Clinical Social Worker · Portland, OR
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Create Change, LLC is a Clinical Social Worker organization in Portland, OR (NPI 1407210867).
Provider details
- NPI number
- 1407210867
- Entity type
- Organization
- Primary specialty
- Clinical Social WorkerBehavioral Health & Social Service Providers
- Organization subpart
- No
- Authorized official
- Sheila Walty, Director(503) 842-7855
- License
- 2340 (OR)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2016-04-11
- Last updated
- 2016-04-11
Frequently asked questions
- What is Create Change, LLC's NPI number?
- Create Change, LLC's National Provider Identifier (NPI) is 1407210867, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Create Change, LLC?
- Create Change, LLC is classified in the NPPES registry as Clinical Social Worker (Behavioral Health & Social Service Providers).
- Where is Create Change, LLC located?
- Create Change, LLC's practice location on file with NPPES is 312 Nw 10th Ave, Portland, OR 97209-3121.
- What is Create Change, LLC's phone number?
- The practice phone number listed in the NPPES registry for Create Change, LLC is (503) 842-7855.
- Does Create Change, LLC accept Medicare?
- Create Change, LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Create Change, LLC?
- The authorized official listed on Create Change, LLC's NPPES record is Sheila Walty, Director. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Create Change, LLC's NPI active?
- Yes — Create Change, LLC's NPI (1407210867) is active in the NPPES registry as of the last update on 2016-04-11.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.