Angela Dee Gunn, LCSW CST

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

L6394 Issued in OR

Practice address

5510 N Commercial Ave
Portland, OR 97217-2340

Phone

(414) 550-0257

NPI assigned

Nov 20, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846

  Clinical

  Medicare reassignment NPD
• Liberation Therapy Center LLC

  • Clinical Social Worker
  • Portland, OR
  • NPI 1992560148
  NPD
• Kinship House

  • Community/Behavioral Health Agency
  • Portland, OR
  • NPI 1528462710
  NPD (past)
• Kinship House

  • Psychiatric/Mental Health Nurse Practitioner
  • Portland, OR
  • NPI 1881728087

  Clinical

  NPD (past)

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

{
    "created_epoch": "1321747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587427200000",
    "number": "1194092007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5510 N COMMERCIAL AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972172340",
            "telephone_number": "414-550-0257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5510 N COMMERCIAL AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972172340",
            "telephone_number": "414-550-0257"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1823 NE 8th Ave.",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "97212",
            "country_code": "US",
            "telephone_number": "503-460-2796",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUNN",
        "first_name": "ANGELA",
        "middle_name": "DEE",
        "credential": "LCSW CST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-20",
        "last_updated": "2020-04-21",
        "certification_date": "2020-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "WI",
            "license": "128563-121",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "A3133",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OR",
            "license": "L6394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ali Noel Gunesch, MD
• Emily Rae Gunesch
• Aleksei Marie Gunn
• Alison Leigh Gunn
• Amy Ruth Gunn, LMT
• Bulan Sabile Gunn
• Carol Elizabeth Gunn, M.D.
• Jessica M Gunn, PA-C
• Kristin L Gunn, CADC-R
• Abigail Michelle Gunnink, MS, ATC

• 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 Apr 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.