Individual provider Active NPI

Raquel Stewart-Mendoza, MA, LPCA

  • Professional Counselor
  • Portland, OR
National Provider Identifier
1083392286
Registry record updated Sep 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
C10568 Issued in OR
Practice address
12636 SE Stark St BLDG J
Portland, OR 97233-1058
Phone
(503) 253-4600
NPI assigned
Jul 7, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2025

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 C10568 OR Primary

Addresses

Primary practice location

12636 SE Stark St BLDG J
Portland, OR 97233-1058

Mailing address

12636 SE Stark St Ste 125
Portland, OR 97233-1058

Other names 1

  • Raquel Stewart Professional name

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
I20260107004001 OR Practitioner - Mental Health Counselor 4486130606 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

905 SE 14TH Ave
Portland, OR 97214-2549

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
C10568ORMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Larsen Sanchez Psychology, LLC CurrentSince Jan 19, 2026 Accepting new patients

Locations

812 SW Washington St
Ste 700
Portland, OR 97205
Phone (503) 622-8964

905 SE 14th Ave
Portland, OR 97214
Phone (503) 622-8964

Organizations & group practices 1

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": "1688688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759104000000",
    "number": "1083392286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12636 SE STARK ST STE 125",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972331058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12636 SE STARK ST BLDG J",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972331058",
            "telephone_number": "503-253-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART-MENDOZA",
        "first_name": "RAQUEL",
        "credential": "MA, LPCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-07",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C10568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RAQUEL",
            "last_name": "STEWART",
            "credential": "MA, LPC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.