Individual provider Active NPI

James Philip Clifford

  • Mental Health Counselor
  • Portland, OR
National Provider Identifier
1134531031
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1600 SE Ankeny St
Portland, OR 97214-1448
Phone
(503) 236-7094
NPI assigned
May 27, 2014
Last updated
Oct 2, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

1600 SE Ankeny St
Portland, OR 97214-1448

Mailing address

1600 SE Ankeny St
Portland, OR 97214-1448
Phone (503) 236-7094

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
I20241010001628 OR Practitioner - Mental Health Counselor 7315479755 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1600 SE Ankeny St
Portland, OR 97214-1448
Phone (503) 236-7094

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Artist Eye Counseling Mental Health CurrentSince Sep 18, 2024 Accepting new patients
Three Firs Counseling LLC Mental Health CurrentSince Jan 1, 2023 Accepting new patients
Three Firs Counseling LLC Mental Health CurrentSince Feb 1, 2021 Accepting new patients

Locations

110 SE 16th Ave
Portland, OR 97214
Phone (503) 236-7094

1600 SE Ankeny St
Portland, OR 97214
Phone (503) 236-7094

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, 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": "1401148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1134531031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 SE ANKENY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972141448",
            "telephone_number": "503-236-7094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SE ANKENY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972141448",
            "telephone_number": "503-236-7094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLIFFORD",
        "first_name": "JAMES",
        "middle_name": "PHILIP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-27",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.