Glenn David Maia, M.A.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

707 NE Couch Street
Portland, OR 97232

Phone

(503) 542-4603

Fax

(503) 233-6093

NPI assigned

Sep 17, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA, OR2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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.

• Kaiser Foundation Health Plan of the Northwest

  • General Practice Physician
  • Portland, OR
  • NPI 1184786527

  WA

  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Northwest

  • Clinic/Center
  • Hillsboro, OR
  • NPI 1942718622
  NPD
• Manor Care of Salmon Creek Wa, Association

  dba ProMedica Skilled Nursing and Rehabilitation (Salmon Creek)

  • Skilled Nursing Facility
  • Vancouver, WA
  • NPI 1609171081
  NPD
• Janus Youth Programs

  • Substance Abuse Rehabilitation Facility
  • Portland, OR
  • NPI 1912331646
  NPD (past)
• Janus Youth Programs, Inc.

  • Voluntary or Charitable Agency
  • Portland, OR
  • NPI 1003248642
  NPD (past)

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

{
    "created_epoch": "1379376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379376000000",
    "number": "1114353521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 NE COUCH STREET",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97232",
            "telephone_number": "503-542-4603",
            "fax_number": "503-233-6093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 NE COUCH STREET",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97232",
            "telephone_number": "503-542-4603",
            "fax_number": "503-233-6093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAIA",
        "first_name": "GLENN",
        "middle_name": "DAVID",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-17",
        "last_updated": "2013-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tammy Mai, D.O.
• Thu-Lan V Mai
• Tu Mai, DO
• Tuyet Nhi T Mai, MD
• Vivian Vy Hoang Mai, DPT, PT
• David Maiava-Hall, MSCP
• Rachel Elizabeth Maiden
• Maidenhair-Bird in Hand Electrology Group, LLC
• Abby Lottridge Maier, LCSW RN
• Andrew Michael Maier

• Mental Health Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.