Active NPI
Sebastian Molfa
- Professional Counselor
- Portland, OR
National Provider Identifier
1003211350
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- C4044
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MC60418527 | WA | MD | Mental Health Counselor |
| C4044 | OR | MD | Professional Counselor |
| LMT22244 | OR | MD | Massage Therapist |
| MA60177340 | WA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lutheran Community Services Northwest | Current | Accepting new patients | |
| Lutheran Community Services Northwest | Current | 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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Portland, OR
- NPI 1326056433
-
- Community/Behavioral Health Agency
- McMinnville, OR
- NPI 1255542106
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.