Active NPI
Lindley Robert Johnson, LPC, MAC
- Counselor
- Portland, OR
National Provider Identifier
1124177050
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 621 SW Alder St
Suite 520
Portland, OR 97205-3626 - Phone
- (503) 494-4745
- Fax
- (205) 494-4747
- NPI assigned
- Jan 9, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
621 SW Alder St
Suite 520
Portland, OR 97205-3626
Mailing address
621 SW Alder St Ste 520
Portland, OR 97205-3620
Phone (503) 418-0885
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
15700 SW Greystone CT
Beaverton, OR 97006-6011
Phone (503) 494-3442
2525 SW 1St Ave
Portland, OR 97201-4753
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Professional Services | Current | Accepting new patients | |
| University Professional Services | Current | Accepting new patients | |
| University Professional Services | Current | Accepting new patients |
Locations
15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000
621 SW Alder St
Ste 520
Portland, OR 97205
Phone (503) 418-5311
Organizations & group practices 3
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.
-
- General Practice Physician
- Portland, OR
- NPI 1376709535
-
- Pharmacy
- Beaverton, OR
- NPI 1073054714
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Portland, OR
- NPI 1316354970
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378857600000",
"number": "1124177050",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "621 SW ALDER ST STE 520",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972053620",
"telephone_number": "503-418-0885"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "621 SW ALDER ST",
"address_2": "SUITE 520",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972053626",
"telephone_number": "503-494-4745",
"fax_number": "205-494-4747"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "LINDLEY",
"middle_name": "ROBERT",
"credential": "LPC, MAC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-09",
"last_updated": "2013-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"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 Sep 11, 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.
- 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.