Myndravyn,LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

MYNDRAVYN,LLC

Practice address

12150 SW Westfall Rd
Sherwood, OR 97140-7207

Phone

(503) 545-8688

NPI assigned

Mar 13, 2023

Last updated

Jul 6, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shameka Sealsadjei

Title

Revenue Cycle Manager

Phone

(360) 998-7072

Specialties & licenses 2

Addresses

Other names 1

• MyndRavyn Creative Counseling Solutions Other name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Maggie McKenzie Young Greensmith

  • Case Manager/Care Coordinator
  • Sherwood, OR
  • NPI 1235833534
  NPD

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

{
    "created_epoch": "1678665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688601600000",
    "number": "1245931666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31070 SW WILLAMETTE WAY E",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970709595",
            "telephone_number": "503-545-8688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12150 SW WESTFALL RD",
            "city": "SHERWOOD",
            "state": "OR",
            "postal_code": "971407207",
            "telephone_number": "503-545-8688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYNDRAVYN,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-13",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A",
        "authorized_official_last_name": "SEALSADJEI",
        "authorized_official_first_name": "SHAMEKA",
        "authorized_official_title_or_position": "REVENUE CYCLE MANAGER",
        "authorized_official_telephone_number": "360-998-7072"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MyndRavyn Creative Counseling Solutions",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Patricia Eden Fernandez Millan, M.D.
• Tycie Leeann Monson, MS
• James R Morelli, DDS
• Barbara Jo Morgan
• Joshua A Morris, PH.D.
• Stefan Nedelcu, D.M.D
• Kira Elise Negrete
• Rebecca Jane Ness, PT
• Next Level Chiropractic of Sherwood
• Kelly Rae Nickel-Dubin

• Mental Health Counselor in Sherwood, OR
• Providers in Sherwood, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.