Lisa Pauline Knudsen, LPC, CADCII

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C4979 Issued in OR

Practice address

20512 SW Roy Rogers Rd
Suite 150
Sherwood, OR 97140

Phone

(503) 341-2694

NPI assigned

Dec 3, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1480723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536192000000",
    "number": "1083157416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20512 SW ROY ROGERS RD",
            "address_2": "SUITE 150",
            "city": "SHERWOOD",
            "state": "OR",
            "postal_code": "971409929",
            "telephone_number": "503-341-2694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20512 SW ROY ROGERS RD",
            "address_2": "SUITE 150",
            "city": "SHERWOOD",
            "state": "OR",
            "postal_code": "97140",
            "telephone_number": "503-341-2694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNUDSEN",
        "first_name": "LISA",
        "middle_name": "PAULINE",
        "credential": "LPC, CADCII",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-03",
        "last_updated": "2018-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "03-03-60",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C4979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela Ann Keys
• Christopher Khodadadian, RN
• Julie Christine Kirchner, MFT
• Heidi Elizabeth Klein, LMT
• Gillette M Knirk, PA-C
• Russell J Kort, D.C.
• Kristan D Rodriguez DDS LLC
• Kristy Baker PSYD LLC
• Kristine Kuntzelman, LMT
• Kathleen Marie Labavitch, LMT

• Professional Counselor in Sherwood, OR
• Providers in Sherwood, OR by specialty
• Professional Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2018; 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.