Individual provider Active NPI

Randa Gahin, LMFT, LPC

  • Marriage & Family Therapist
  • Portland, OR
National Provider Identifier
1164651733
Registry record updated Jan 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
R1437 (PC) Issued in OR
Practice address
1832 NE Broadway St.
Portland, OR 97232
Phone
(503) 347-4863
NPI assigned
Jul 4, 2009
Last updated
Jan 24, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X R1437 (PC) OR
Marriage & Family Therapist 106H00000X R1437 (PC) OR Primary

Addresses

Primary practice location

1832 NE Broadway St.
Portland, OR 97232

Mailing address

1832 NE Broadway St.
Portland, OR 97232
Phone (503) 347-4863

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 1, 2024 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
R1437 (PC)ORMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1246665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579824000000",
    "number": "1164651733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1832 NE BROADWAY ST.",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97232",
            "telephone_number": "503-347-4863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1832 NE BROADWAY ST.",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97232",
            "telephone_number": "503-347-4863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAHIN",
        "first_name": "RANDA",
        "credential": "LMFT, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-04",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "R1437 (PC)",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OR",
            "license": "R1437 (PC)",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.