Individual provider Active NPI

Mamta Bhargava, NCC, LPC

  • Professional Counselor
  • Portland, OR
National Provider Identifier
1235375981
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
C8032 Issued in OR
Practice address
4351 SW Vesta St
Portland, OR 97219-7452
Phone
(480) 252-2860
NPI assigned
Dec 31, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC 13800 AZ
Professional Counselor 101YP2500X C8032 OR Primary

Addresses

Primary practice location

4351 SW Vesta St
Portland, OR 97219-7452

Mailing address

4351 SW Vesta St
Portland, OR 97219-7452
Phone (480) 252-2860

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
I20241209003782 OR Practitioner - Mental Health Counselor 2769918184 Reassigns benefits to 1 organization
Practice locations: Portland, OR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC 13800AZMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Portland DBT Institute, Inc. CurrentSince Dec 2, 2024 Accepting new patients

Locations

5200 S Macadam Ave
Ste 580
Portland, OR 97239
Phone (503) 231-7854

5100 S Macadam Ave
Ste 350
Portland, OR 97239
Phone (503) 231-7854

Organizations & group practices 1

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": "1230681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1235375981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4351 SW VESTA ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972197452",
            "telephone_number": "480-252-2860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4351 SW VESTA ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972197452",
            "telephone_number": "480-252-2860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHARGAVA",
        "first_name": "MAMTA",
        "name_prefix": "Mrs.",
        "credential": "NCC, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-31",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC 13800",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C8032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.