Individual provider Active NPI

Tiffany Marie Bryant, LPC

  • Mental Health Counselor
  • Portland, OR
National Provider Identifier
1043959638
Registry record updated Jul 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C9021 Issued in OR
Practice address
1033 SW Yamhill St Ste 201
Portland, OR 97205-2538
Phone
(971) 990-5762
NPI assigned
Jun 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X C9021 OR Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Mental Health Counselor 101YM0800X LPC-21496 AZ

Addresses

Primary practice location

1033 SW Yamhill St Ste 201
Portland, OR 97205-2538

Mailing address

12317 W Denton Ave
Litchfield Park, AZ 85340-3434
Phone (513) 252-6939

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
I20250930003706 OR Practitioner - Mental Health Counselor 3779089685 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1033 SW Yamhill St
Suite 201
Portland, OR 97205-2538

12317 W Denton Ave
Litchfield Park, AZ 85340-3434

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC-21496AZMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Healed Phoenix Counseling and Wellness Center LLC Mental Health CurrentSince Dec 31, 2023 Accepting new patients
Healed Phoenix Counseling and Wellness Center LLC Mental Health Current Accepting new patients
Healed Phoenix Behavioral Health LLC CurrentSince Jul 13, 2025 Accepting new patients

Locations

4225 W Glendale Ave
Ste A201
Phoenix, AZ 85051
Phone (623) 258-1904

1033 SW Yamhill St
Ste 101
Portland, OR 97205
Phone (513) 252-6939

1033 SW Yamhill St
Ste 201
Portland, OR 97205
Phone (513) 252-3206

Organizations & group practices 3

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": "1654041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785196800000",
    "number": "1043959638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12317 W DENTON AVE",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853403434",
            "telephone_number": "513-252-6939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1033 SW YAMHILL ST STE 201",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052538",
            "telephone_number": "971-990-5762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "TIFFANY",
        "middle_name": "MARIE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-01",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C9021",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LPC-21496",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.