Nicole Marie Estrada, LMFT, LPC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

T0986 Issued in OR

Practice address

9615 Grand Ronde Rd
Grand Ronde, OR 97347-9712

Phone

(503) 879-2026

Fax

(503) 879-4606

NPI assigned

Apr 23, 2012

Last updated

Oct 14, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

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": "1335139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413244800000",
    "number": "1093073439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9615 GRAND RONDE RD",
            "city": "GRAND RONDE",
            "state": "OR",
            "postal_code": "973479712",
            "telephone_number": "503-879-2026",
            "fax_number": "503-879-4606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9615 GRAND RONDE RD",
            "city": "GRAND RONDE",
            "state": "OR",
            "postal_code": "973479712",
            "telephone_number": "503-879-2026",
            "fax_number": "503-879-4606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTRADA",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "credential": "LMFT, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-23",
        "last_updated": "2014-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "IMF 54034",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF 54034",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT77123",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OR",
            "license": "T0986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Confederated Tribes of the Grand Ronde Community of Oregon (Confederated Tribes of Grand Ronde Health & Wellness Center Pharmacy)
• Joseph Shane Cox
• Dorothy R De la Rosa, CDAC II
• Cyaandi Rhone Dove, D.P.M.
• Casey Eash, LPC, CADC I
• Carolyn S Fairfax, MD
• Troyce Fortune
• Amber Foster, CRM
• Shelly Rae Fox
• Jill Goodwin, LPC, MFT, ATR

• Marriage & Family Therapist in Grand Ronde, OR
• Providers in Grand Ronde, OR by specialty
• Marriage & Family Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2014; 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.