Individual provider Active NPI

Teresa A Naimo, LPC NCC

  • Counselor
  • Portland, OR
National Provider Identifier
1194886929
Registry record updated Dec 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
LPCC1688 Issued in OR
Practice address
19500 SE Stark St
Portland, OR 97233-5757
Phone
(503) 253-4600
Fax
(503) 253-4609
NPI assigned
Dec 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X LPCC1688 OR Primary

Addresses

Primary practice location

19500 SE Stark St
Portland, OR 97233-5757

Mailing address

PO Box 82819
Portland, OR 97282
Phone (503) 233-5405

Other identifiers 1

IdentifierTypeStateIssuer
164936MedicaidOR

Other names 1

  • Teresa Schulze Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240102003707 OR Practitioner - Mental Health Counselor 7719337815 Reassigns benefits to 1 organization
I20240111004993 WA Practitioner - Mental Health Counselor 7719337815 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPCC1688ORMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest Counselor CurrentSince Jan 1, 2024 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Counselor Current Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Jan 1, 2024 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Counselor CurrentSince Jan 1, 2024 Accepting new patients

Locations

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

19500 SE Stark St
Portland, OR 97233
Phone (503) 669-3900

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

14406 NE 20th Ave
Vancouver, WA 98686
Phone (360) 418-6001

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1194886929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 82819",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97282",
            "telephone_number": "503-233-5405",
            "fax_number": "503-233-2696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19500 SE STARK ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972335757",
            "telephone_number": "503-253-4600",
            "fax_number": "503-253-4609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAIMO",
        "first_name": "TERESA",
        "middle_name": "A",
        "credential": "LPC NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OR",
            "license": "LPCC1688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164936",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Careequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "19500 SE Stark St",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972335757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TERESA",
            "last_name": "SCHULZE",
            "credential": "LPC NCC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.