Individual provider Active NPI

Cynthia Ross Connais

  • Mental Health Counselor
  • Portland, OR
National Provider Identifier
1285079194
Registry record updated Jul 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
3034 NE MLK Blvd
Portland, OR 97212-3053
Phone
(503) 889-2500
NPI assigned
May 6, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 13-R-02 OR
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

3034 NE MLK Blvd
Portland, OR 97212-3053

Mailing address

PO Box 8459
Portland, OR 97207-8459
Phone (503) 238-0769

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
I20231205002878 OR Practitioner - Mental Health Counselor 9537518345 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Professional ServicesGroup PAC ID 4880760107, 1,683 clinicians

Practice addresses (Care Compare)

15700 SW Greystone CT
Beaverton, OR 97006-6011
Phone (503) 494-3442

2525 SW 1St Ave
Portland, OR 97201-4753

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13-R-02ORMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
University Professional Services CurrentSince Jan 1, 2024 Accepting new patients
University Professional Services Current Accepting new patients
University Professional Services CurrentSince Jan 1, 2024 Accepting new patients
Cascadia Health Past Accepting new patients
Cascadia Health Past Accepting new patients

Locations

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

Organizations & group practices 5

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": "1367798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374796800000",
    "number": "1285079194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8459",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972078459",
            "telephone_number": "503-238-0769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3034 NE MLK BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972123053",
            "telephone_number": "503-889-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNAIS",
        "first_name": "CYNTHIA",
        "middle_name": "ROSS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-06",
        "last_updated": "2013-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "13-R-02",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.