Marley Elizabeth Small, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

IMF100752 Issued in CA

Practice address

1507 NE 122ND Ave.
Portland, OR 97230

Phone

(503) 258-4475

Fax

(503) 493-2656

NPI assigned

Aug 11, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Marley Elizabeth Villanueva Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Morrison Child and Family Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Portland, OR
  • NPI 1346382975
  NPD (past)

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

{
    "created_epoch": "1502409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1063937951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 NE 122ND AVE.",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97230",
            "telephone_number": "503-258-4475",
            "fax_number": "503-493-2656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 NE 122ND AVE.",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97230",
            "telephone_number": "503-258-4475",
            "fax_number": "503-493-2656"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "335 E Lake Ave",
            "address_purpose": "LOCATION",
            "city": "Watsonville",
            "state": "CA",
            "postal_code": "950764826",
            "country_code": "US",
            "telephone_number": "831-728-6445",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMALL",
        "first_name": "MARLEY",
        "middle_name": "ELIZABETH",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-11",
        "last_updated": "2022-07-21",
        "certification_date": "2020-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "IMF100752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARLEY",
            "last_name": "VILLANUEVA",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Chelsea Small, LMT
• Chenoa Small, BA
• Dixie L.Y. Small, LAC, DAOM
• Gabrielle Small
• Julian Small, LPC
• Phillip Small, PHD
• Sarah Katherine Small, LPC
• Victoria Lynn Small
• Hannah Lee Smargiassi
• Samantha Lee Smargiassi, LMT

• Mental Health Counselor in Portland, OR
• Providers in Portland, 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 21, 2022; 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.