Individual provider Active NPI

Joanna Harberts

  • Clinical Psychologist
  • Milwaukie, OR
National Provider Identifier
1114122942
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3717 Issued in OR
Practice address
6400 SE Lake Rd Ste 325
Milwaukie, OR 97222-2185
Phone
(503) 786-1711
NPI assigned
Jun 20, 2007
Last updated
Feb 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 3717 OR Primary

Addresses

Primary practice location

6400 SE Lake Rd Ste 325
Milwaukie, OR 97222-2185

Mailing address

6400 SE Lake Rd Ste 325
Milwaukie, OR 97222-2185
Phone (503) 786-1711

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
I20231115002497 OR Practitioner - Clinical Psychologist 2264889096 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cornerstone Clinical Services PCGroup PAC ID 3274523378, 16 clinicians

Practice addresses (Care Compare)

6400 SE Lake Rd
Suite 325
Milwaukie, OR 97222-2185
Phone (503) 786-1711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Clinical Services PC CurrentSince Oct 12, 2023 Accepting new patients
Cornerstone Clinical Services, Inc CurrentSince Oct 12, 2023 Accepting new patients

Locations

6400 SE Lake Rd
Ste 325
Portland, OR 97222
Phone (503) 786-1711

7340 SW Hunziker Rd
Ste 210
Tigard, OR 97223
Phone (503) 352-0036

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1114122942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 SE LAKE RD STE 325",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972222185",
            "telephone_number": "503-786-1711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 SE LAKE RD STE 325",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972222185",
            "telephone_number": "503-786-1711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARBERTS",
        "first_name": "JOANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-20",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "3717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukie, OR

Sources for this page

Verify at the official NPI Registry.