Active NPI
Stephanie Michelle Caballero, LMFT
- Marriage & Family Therapist
- Portland, OR
National Provider Identifier
1104237692
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- T1596
- Practice address
- 827 NE Alberta St.
Portland, OR 97211 - Phone
- (626) 460-0603
- Fax
- (971) 200-2421
- NPI assigned
- May 19, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | T1596 | OR | Primary |
Addresses
Primary practice location
827 NE Alberta St.
Portland, OR 97211
Mailing address
827 NE Alberta St.
Portland, OR 97211
Phone (626) 460-0603
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| T1596 | Other | OR | LICENSED MARRIAGE AND FAMILY THERAPIST |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T1596 | OR | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400457600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617840000000",
"number": "1104237692",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "827 NE ALBERTA ST.",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97211",
"telephone_number": "626-460-0603",
"fax_number": "971-200-2421"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "827 NE ALBERTA ST.",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97211",
"telephone_number": "626-460-0603",
"fax_number": "971-200-2421"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CABALLERO",
"first_name": "STEPHANIE",
"middle_name": "MICHELLE",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-05-19",
"last_updated": "2021-04-08",
"certification_date": "2021-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "OR",
"license": "T1596",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSED MARRIAGE AND FAMILY THERAPIST",
"identifier": "T1596",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.