Individual provider Active NPI

Jennifer Lynn Pitt, LMFT

  • Marriage & Family Therapist
  • Gladstone, OR
National Provider Identifier
1013257542
Registry record updated Feb 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
T0508 Issued in OR
Practice address
890 82ND Dr
Gladstone, OR 97027-1803
Phone
(503) 233-5405
NPI assigned
Feb 20, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X T0508 OR Primary

Addresses

Primary practice location

890 82ND Dr
Gladstone, OR 97027-1803

Mailing address

890 82ND Dr
Gladstone, OR 97027-1803
Phone (503) 233-5405

Other identifiers 1

IdentifierTypeStateIssuer
164936MedicaidOR

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
I20240321002919 OR Practitioner - Marriage and Family Therapist 0941647200 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brightspire Health LLCGroup PAC ID 2163866419, 27 clinicians

Practice addresses (Care Compare)

9670 SW Beaverton Hillsdale Hwy
Beaverton, OR 97005-3307
Phone (971) 229-4009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
T0508ORMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Brightspire Health, LLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

9670 SW Beaverton Hillsdale Hwy
Beaverton, OR 97005
Phone (503) 626-9494

890 82nd Dr
Gladstone, OR 97027
Phone (503) 659-5515

10824 SE Oak St
Portland, OR 97222
Phone (717) 516-1080

825 NE 20th Ave
Ste 120
Portland, OR 97232
Phone (971) 229-4009

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": "1361318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361318400000",
    "number": "1013257542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "890 82ND DR",
            "city": "GLADSTONE",
            "state": "OR",
            "postal_code": "970271803",
            "telephone_number": "503-233-5405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 82ND DR",
            "city": "GLADSTONE",
            "state": "OR",
            "postal_code": "970271803",
            "telephone_number": "503-233-5405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITT",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-20",
        "last_updated": "2013-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OR",
            "license": "T0508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164936",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gladstone, OR

Sources for this page

Verify at the official NPI Registry.