Individual provider Active NPI

Taylor Genevieve Hansen

  • Mental Health Counselor
  • Lake Oswego, OR
National Provider Identifier
1053803916
Registry record updated Jul 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
2507 Christie Dr.
Lake Oswego, OR 97034
Phone
(503) 635-3416
NPI assigned
Jun 5, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

2507 Christie Dr.
Lake Oswego, OR 97034

Mailing address

018 SW Boundary CT
Portland, OR 97239-3939

Other practice location 1

1942 NW Overton St
Portland, OR 97209-1619
Phone (503) 729-8689

Other practice location 2

018 SW Boundary Ct
Portland, OR 97239-3939
Phone (503) 222-9661

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
I20231127002623 OR Practitioner - Clinical Social Worker 3577911841 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Portland ClinicGroup PAC ID 8224942867, 93 clinicians

Practice addresses (Care Compare)

6640 SW Redwood LN
Portland, OR 97224-7187
Phone (603) 620-7358

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Options for Southern Oregon Current Accepting new patients
Portland Clinic CurrentSince Sep 1, 2024 Accepting new patients
Options for Southern Oregon CurrentSince Oct 29, 2023 Accepting new patients
Youth Villages Past Accepting new patients
Youth Villages Past Accepting new patients

Locations

1215 SW G St
Grants Pass, OR 97526
Phone (541) 244-4109

1545 Harbeck Rd
Grants Pass, OR 97527
Phone (541) 479-2371

200 Beatty St
Medford, OR 97501
Phone (541) 414-0739

6640 SW Redwood Ln
Portland, OR 97224
Phone (503) 620-7358

9250 SW Hall Blvd
Tigard, OR 97223
Phone (503) 221-0161

Organizations & group practices 5

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": "1528156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561939200000",
    "number": "1053803916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "018 SW BOUNDARY CT",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2507 CHRISTIE DR.",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "97034",
            "telephone_number": "503-635-3416"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1942 NW Overton St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972091619",
            "country_code": "US",
            "telephone_number": "503-729-8689",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "018 SW Boundary Ct",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972393939",
            "country_code": "US",
            "telephone_number": "503-222-9661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "TAYLOR",
        "middle_name": "GENEVIEVE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-05",
        "last_updated": "2019-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Oswego, OR

Sources for this page

Verify at the official NPI Registry.