Individual provider Active NPI

Elizabeth Marie Gregory, M.A.

  • Mental Health Counselor
  • Portland, OR
National Provider Identifier
1205274156
Registry record updated Jun 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C2804 Issued in OR
Practice address
5319 SW Westgate Dr
Portland, OR 97221-2411
Phone
(503) 330-8677
NPI assigned
Jun 12, 2013
Last updated
Jun 12, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X C2804 OR Primary

Addresses

Primary practice location

5319 SW Westgate Dr
Portland, OR 97221-2411

Mailing address

4625 SW 45TH Ave
Portland, OR 97221-3618
Phone (503) 200-4746

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
I20240124004186 OR Practitioner - Marriage and Family Therapist 9032562111 Practice locations: Portland, OR

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5319 SW Westgate Dr
Suite 113
Portland, OR 97221-2432
Phone (503) 200-4746

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C2804ORMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1370995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370995200000",
    "number": "1205274156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4625 SW 45TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972213618",
            "telephone_number": "503-200-4746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5319 SW WESTGATE DR",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972212411",
            "telephone_number": "503-330-8677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGORY",
        "first_name": "ELIZABETH",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-12",
        "last_updated": "2013-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C2804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.