Organization Active NPI

Teletherapeutics Health Inc.

  • Clinical Psychologist
  • Portland, OR
National Provider Identifier
1154064590
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
TELETHERAPEUTICS HEALTH INC.
Practice address
10350 N Vancouver Way # 1092
Portland, OR 97217-7530
Phone
(888) 420-0589
NPI assigned
Apr 14, 2022
Reactivated
Oct 4, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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

Authorized official

Name
Yasir J. Ahmad, MD
Title
Owner
Phone
(732) 485-1301

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

10350 N Vancouver Way # 1092
Portland, OR 97217-7530

Mailing address

79 Ogle Rd
Old Tappan, NJ 07675-7026
Phone (888) 420-0589

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1649894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730073600000",
    "number": "1154064590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 OGLE RD",
            "city": "OLD TAPPAN",
            "state": "NJ",
            "postal_code": "076757026",
            "telephone_number": "888-420-0589",
            "fax_number": "302-469-2115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10350 N VANCOUVER WAY # 1092",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972177530",
            "telephone_number": "888-420-0589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TELETHERAPEUTICS HEALTH INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-14",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "deactivation_date": "2022-08-06",
        "reactivation_date": "2022-10-04",
        "status": "A",
        "authorized_official_last_name": "AHMAD",
        "authorized_official_first_name": "YASIR",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-485-1301",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "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 Oct 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.