Individual provider Active NPI

Sebastian Molfa

  • Professional Counselor
  • Portland, OR
National Provider Identifier
1003211350
Registry record updated May 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
C4044 Issued in OR
Practice address
605 SE Cesar E Chavez Blvd
Portland, OR 97214-3216
Phone
(503) 231-7480
Fax
(503) 233-0667
NPI assigned
Oct 29, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MC60418527 WA
Mental Health Counselor 101YM0800X C4044 OR
Massage Therapist 225700000X MA60177340 WA
Professional Counselor 101YP2500X C4044 OR Primary
Massage Therapist 225700000X LMT22244 OR

Addresses

Primary practice location

605 SE Cesar E Chavez Blvd
Portland, OR 97214-3216

Mailing address

605 SE Cesar E Chavez Blvd
Portland, OR 97214-3216
Phone (503) 231-7480

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241108003634 OR Practitioner - Mental Health Counselor 3870027105 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MC60418527WAMDMental Health Counselor
C4044ORMDProfessional Counselor
LMT22244ORMDMassage Therapist
MA60177340WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lutheran Community Services Northwest CurrentSince Sep 2, 2024 Accepting new patients
Lutheran Community Services Northwest CurrentSince Sep 2, 2024 Accepting new patients

Locations

605 SE Cesar E Chavez Blvd
Portland, OR 97214
Phone (503) 731-9539

4040 S 188th St
Ste 300
Seatac, WA 98188
Phone (206) 816-3253

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1414540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684972800000",
    "number": "1003211350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 SE CESAR E CHAVEZ BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972143216",
            "telephone_number": "503-231-7480",
            "fax_number": "503-233-0667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 SE CESAR E CHAVEZ BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972143216",
            "telephone_number": "503-231-7480",
            "fax_number": "503-233-0667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLFA",
        "first_name": "SEBASTIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-29",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MC60418527",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C4044",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60177340",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C4044",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "LMT22244",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.