Lupita Pena-Baltazar, QMHA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L10733 Issued in OR

Practice address

1310 Meridian Dr
Woodburn, OR 97071-9668

Phone

(503) 953-0310

Fax

(503) 386-0439

NPI assigned

May 7, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Lupita Pena Former name

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

Specialty

Clinical Social Worker

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Brightways Counseling Group LLCGroup PAC ID 4688907827, 36 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Brightways Counseling Group LLC

  • Group Psychotherapy Psychologist
  • Redmond, OR
  • NPI 1689191165

  Clinical

  Medicare reassignment Care Compare group NPD
• Bright Horizons Psychiatric Group LLC

  • Child & Adolescent Psychiatric/Mental Health Registered Nurse
  • Redmond, OR
  • NPI 1629724695
  NPD

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

{
    "created_epoch": "1241654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1104050947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7515 FALCON CREST DR # 200",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977565014",
            "telephone_number": "541-904-5216",
            "fax_number": "541-527-4347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 MERIDIAN DR",
            "city": "WOODBURN",
            "state": "OR",
            "postal_code": "970719668",
            "telephone_number": "503-953-0310",
            "fax_number": "503-386-0439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA-BALTAZAR",
        "first_name": "LUPITA",
        "name_prefix": "Miss",
        "credential": "QMHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-07",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L10733",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OREGON BOARD OF LICENSED SOCIAL WORKERS",
            "identifier": "L10733",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LUPITA",
            "last_name": "PENA",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Suzanne Paterson, RN
• Barbara Patino Flores
• Patrick C McDonald MD PC
• Jill C Pearson, MD
• Shannon Pearson, PHARMD
• Jesus Perez-Sanchez
• Yanira A Perez, INTERPRETER
• Katherine Peters, PHARMD
• Virgil E Peters, MD
• Elena Piceno

• Clinical Social Worker in Woodburn, OR
• Providers in Woodburn, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.