Light Mind Wellness

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Legal business name

LIGHT MIND WELLNESS

Practice address

6734 SE Raymond St
Portland, OR 97206-4520

Phone

(503) 926-9567

NPI assigned

Jan 1, 2021

Organization subpart

No

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

Authorized official

Name

Julia Perretta, LMFTNPI 1518377167

Title

Owner/Practitioner

Phone

(503) 926-9567

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Light Mind Wellness Other name

Electronic endpoints 1

Practitioners 1

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

• Julia Perretta, MS, LMFT

  • Marriage & Family Therapist
  • Portland, OR
  • NPI 1518377167
  NPD Authorized official

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

{
    "created_epoch": "1609459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613347200000",
    "number": "1174111561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5010 SE FOSTER RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972063039",
            "telephone_number": "503-926-9567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6734 SE RAYMOND ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972064520",
            "telephone_number": "503-926-9567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHT MIND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-01",
        "last_updated": "2021-02-15",
        "certification_date": "2021-02-15",
        "status": "A",
        "authorized_official_last_name": "PERRETTA",
        "authorized_official_first_name": "JULIA",
        "authorized_official_title_or_position": "OWNER/PRACTITIONER",
        "authorized_official_telephone_number": "503-926-9567",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL NPI",
            "identifier": "1518377167",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "***",
            "affiliation": "N",
            "address_1": "6734 SE Raymond St",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972064520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Light Mind Wellness",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Light Mind Wellness",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Lifeweighs (LifeWeighs LLC)
• Lifeworks Northwest
• Lifeworks Northwest
• Lifeworks Northwest
• Lifeworks NW
• Light Side Wellness Co.
• Light Within Therapy LLC
• Gretchen Elizabeth Light, MA
• Jacob D Light, M.D.
• Lindi Jo Fawn Light, QMHA

• Marriage & Family Therapist in Portland, OR
• Providers in Portland, OR by specialty
• Marriage & Family Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2021; 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.