Serendib Psychological Services, LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

SERENDIB PSYCHOLOGICAL SERVICES, LLC

Practice address

14523 Westlake Dr
Lake Oswego, OR 97035-7700

Phone

(971) 373-0415

Fax

(971) 333-8352

NPI assigned

Oct 22, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Kushanthi Surini Samaratunge, PSY.DNPI 1265605133

Title

Owner

Phone

(971) 373-0415

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kushanthi Surini Samaratunge, PSYD

  • Psychologist
  • Tigard, OR
  • NPI 1265605133
  NPD Authorized official

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

{
    "created_epoch": "1603324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604188800000",
    "number": "1275132979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14523 WESTLAKE DR",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970357700",
            "telephone_number": "971-373-0415",
            "fax_number": "971-333-8352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14523 WESTLAKE DR",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970357700",
            "telephone_number": "971-373-0415",
            "fax_number": "971-333-8352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENDIB PSYCHOLOGICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-22",
        "last_updated": "2020-11-01",
        "certification_date": "2020-11-01",
        "status": "A",
        "authorized_official_last_name": "SAMARATUNGE",
        "authorized_official_first_name": "KUSHANTHI",
        "authorized_official_middle_name": "SURINI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "971-373-0415",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lianna Charlee Semonsen
• Amber Marie Senger, LPC ASSOCIATE
• Senua Counseling Clinic
• Senua Counseling Clinic, LLC
• Serenaissance LLC
• Serenity Bodywork
• Ulyana V Seryankina, LMT
• Jeffrey David Sessions, D.M.D.
• Seth S Williams PSYD LLC
• Cameron Seymour

• Psychologist in Lake Oswego, OR
• Providers in Lake Oswego, OR by specialty
• Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2020; 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.