Individual provider Active NPI

Johanna Courtleigh, M.A., L.P.C.

  • Professional Counselor
  • Lake Oswego, OR
National Provider Identifier
1063536258
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
C1612 Issued in OR
Practice address
14523 Westlake Dr
Lake Oswego, OR 97035-7700
Phone
(503) 684-8481
NPI assigned
Mar 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X C1612 OR Primary

Addresses

Primary practice location

14523 Westlake Dr
Lake Oswego, OR 97035-7700

Mailing address

3 Monroe Pkwy # P-442
Lake Oswego, OR 97035-1486
Phone (503) 684-8481

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
C1612ORMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063536258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 MONROE PKWY # P-442",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970351486",
            "telephone_number": "503-684-8481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14523 WESTLAKE DR",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970357700",
            "telephone_number": "503-684-8481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COURTLEIGH",
        "first_name": "JOHANNA",
        "name_prefix": "Ms.",
        "credential": "M.A., L.P.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C1612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Oswego, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.