Phil Bergland, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C3611 Issued in OR

Practice address

11220 SE Stark St
Suite 6
Portland, OR 97216

Phone

(503) 908-4681

NPI assigned

Jul 29, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1438128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472774400000",
    "number": "1174908321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15114 NE 5TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986848108",
            "telephone_number": "360-980-2326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11220 SE STARK ST",
            "address_2": "SUITE 6",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97216",
            "telephone_number": "503-908-4681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGLAND",
        "first_name": "PHIL",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-29",
        "last_updated": "2016-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C3611",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WA",
            "license": "LH60618681",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lucija Bergere
• Sara Janelle Bergeron, BSN, RN
• Lance Bergeson, D.M.D
• Jade Bergez, PMHNP
• Marguerite Bergin, LMT
• Sonia Bergler, LPTA
• Danielle Berglund, MD
• Kate C Berglund, PA-C
• Kristen A Berglund, M.A., LPC
• Alice Bergman, LPC

• Mental Health Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2016; 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.