Individual provider Active NPI

Tina Gilbertson, L.P.C.

  • Mental Health Counselor
  • Portland, OR
National Provider Identifier
1215215892
Registry record updated Jul 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C2577 Issued in OR
Practice address
1235 SE Division St
Suite 207
Portland, OR 97202-1099
Phone
(503) 544-6179
NPI assigned
Jul 29, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2011

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 C2577 OR Primary

Addresses

Primary practice location

1235 SE Division St
Suite 207
Portland, OR 97202-1099

Mailing address

1235 SE Division St
Suite 207
Portland, OR 97202-1099
Phone (503) 544-6179

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Feb 6, 2025 through Feb 6, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
C2577ORMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1311897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311897600000",
    "number": "1215215892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1235 SE DIVISION ST",
            "address_2": "SUITE 207",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972021099",
            "telephone_number": "503-544-6179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 SE DIVISION ST",
            "address_2": "SUITE 207",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972021099",
            "telephone_number": "503-544-6179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILBERTSON",
        "first_name": "TINA",
        "credential": "L.P.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-29",
        "last_updated": "2011-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C2577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.