Individual provider Active NPI

Randi Weber Thoma, LPC

  • Mental Health Counselor
  • Portland, OR
National Provider Identifier
1013001692
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C1115 Issued in OR
Practice address
4800 S Macadam Ave Ste 350
Portland, OR 97239-3970
Phone
(503) 684-7948
Fax
(503) 684-7958
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 61123327 WA
Mental Health Counselor 101YM0800X C1115 OR Primary

Addresses

Primary practice location

4800 S Macadam Ave Ste 350
Portland, OR 97239-3970

Mailing address

4800 S Macadam Ave Ste 350
Portland, OR 97239-3970
Phone (503) 684-7948

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
I20240124002911 OR Practitioner - Mental Health Counselor 8426401662 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4800 S Macadam Ave
Suite 350
Portland, OR 97239-3970
Phone 50368479482

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61123327WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Randi Weber, LPC PC Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

4800 S Macadam Ave
Ste 350
Portland, OR 97239
Phone (503) 297-6656

Organizations & group practices 1

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1013001692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 S MACADAM AVE STE 350",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393970",
            "telephone_number": "503-684-7948",
            "fax_number": "503-684-7958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 S MACADAM AVE STE 350",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393970",
            "telephone_number": "503-684-7948",
            "fax_number": "503-684-7958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMA",
        "first_name": "RANDI",
        "middle_name": "WEBER",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "61123327",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C1115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.