Active NPI
Elizabeth Farrell
- Counselor
- Portland, OR
National Provider Identifier
1285256255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- PROFESSIONALLICENSE
- Practice address
- 12505 SE Raymond Streer
Portland, OR 97236 - Phone
- (503) 760-8300
- Fax
- (503) 760-8308
- NPI assigned
- May 13, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | PROFESSIONALLICENSE | Primary |
Addresses
Primary practice location
12505 SE Raymond Streer
Portland, OR 97236
Mailing address
3587 Heathrow Way
Medford, OR 97504-4004
Phone (541) 858-8170
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Columbiacare Services | Past | Accepting new patients | |
| Columbiacare Services | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Psychiatric Residential Treatment Facility
- Portland, OR
- NPI 1386720142
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Portland, OR
- NPI 1982140588
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1589328000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666137600000",
"number": "1285256255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3587 HEATHROW WAY",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975044004",
"telephone_number": "541-858-8170"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12505 SE RAYMOND STREER",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97236",
"telephone_number": "503-760-8300",
"fax_number": "503-760-8308"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FARRELL",
"first_name": "ELIZABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-13",
"last_updated": "2022-10-19",
"certification_date": "2020-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": "PROFESSIONALLICENSE",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.