Miranda Gambetti, LPC, CADC II

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C3321 Issued in OR

Practice address

1236 14TH St
West Linn, OR 97068-4529

Phone

(971) 267-2217

NPI assigned

Sep 18, 2014

Last updated

Jul 27, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: lifestancehealth.mirandagambetti@148835.advancedmd-direct.com

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

• Western Psychological and Counseling Services LLC

  dba LifeStance Health

  • Clinical Psychologist
  • Tacoma, WA
  • NPI 1912008178

  Addiction (Substance Use Disorder)

  NPD (past)

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

{
    "created_epoch": "1410998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1053713354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1236 14TH ST",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "970684529",
            "telephone_number": "971-267-2217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1236 14TH ST",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "970684529",
            "telephone_number": "971-267-2217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBETTI",
        "first_name": "MIRANDA",
        "credential": "LPC, CADC II",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-18",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "13-R-37",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C3321",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164936",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE",
            "identifier": "0000WDBCH",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Micah Daniel Frey, PT
• Michelle R Friedman, LMT
• Full Bloom Therapy PDX
• Fusion Health Services
• Gabba, N.P., Psychiatric Services
• Ember Gard
• Nicolas Garvoille
• Genteel, LLC
• Gentle Care Chiropractic, LLC
• Andrew Gerry, FNP

• Mental Health Counselor in West Linn, OR
• Providers in West Linn, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.