Individual provider Active NPI

Amy Barrett Lindholm, M.S., LPC

  • Professional Counselor
  • Portland, OR
National Provider Identifier
1164734018
Registry record updated Oct 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
C1517 Issued in OR
Practice address
6274 SW Capitol Hwy
Portland, OR 97239-2674
Phone
(503) 422-7050
NPI assigned
Jul 8, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2023

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 C1517 OR
Professional Counselor 101YP2500X C1517 OR Primary

Addresses

Primary practice location

6274 SW Capitol Hwy
Portland, OR 97239-2674

Mailing address

6274 SW Capitol Hwy
Portland, OR 97239-2674
Phone (503) 422-7050

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
I20240315003239 OR Practitioner - Mental Health Counselor 4082050745 Practice locations: Portland, OR

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6274 SW Capitol Hwy
Portland, OR 97239-2674
Phone (503) 422-7050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
C1517ORMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1278547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1164734018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6274 SW CAPITOL HWY",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972392674",
            "telephone_number": "503-422-7050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6274 SW CAPITOL HWY",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972392674",
            "telephone_number": "503-422-7050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDHOLM",
        "first_name": "AMY",
        "middle_name": "BARRETT",
        "name_prefix": "Ms.",
        "credential": "M.S., LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-08",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C1517",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C1517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.