Embodied Life Therapy Center LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

EMBODIED LIFE THERAPY CENTER LLC

Practice address

6906 N Richards St
Portland, OR 97203-6138

Phone

(971) 336-0338

NPI assigned

Oct 8, 2020

Last updated

Oct 28, 2021By 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

Jennifer Dodd, LCSWNPI 1154896546

Title

Owner

Phone

(971) 266-1081

Specialties & licenses 1

Addresses

Practitioners 3

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.

• Jennifer Marie Dodd, LCSW

  • Clinical Social Worker
  • Portland, OR
  • NPI 1154896546
  NPD Authorized official
• Miranda Tai Campbell Acharya, LCSW

  • Clinical Social Worker
  • Portland, OR
  • NPI 1801290408
  NPD
• Jamie Anderson, MT-BC

  • Music Therapist
  • Portland, OR
  • NPI 1487374229
  NPD

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

{
    "created_epoch": "1602115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635379200000",
    "number": "1265039564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6906 N RICHARDS ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972036138",
            "telephone_number": "971-336-0338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6906 N RICHARDS ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972036138",
            "telephone_number": "971-336-0338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMBODIED LIFE THERAPY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-08",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A",
        "authorized_official_last_name": "DODD",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "971-266-1081",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Khaled Moh Emara, MD
• Embark Counseling NW, LLC
• Autumn Kay Embersong, LMT
• Embodied Chiropractic LLC
• Embodied Consciousness
• Embodied Psychotherapy Inc
• Embodyment Counseling
• Embrace Counseling LLC
• Embrace Orthodontics, LLC
• Embracing Autism ABA, LLC

• Clinical Social Worker in Portland, OR
• Providers in Portland, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2021; 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.