NPIMap

Organization Active NPI

Western Psychological and Counseling Services PC

  • Clinical Psychologist
  • Gladstone, OR
National Provider Identifier
1295130532
Registry record updated Jan 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
WESTERN PSYCHOLOGICAL AND COUNSELING SERVICES PC
Practice address
890 SE 82ND
Gladstone, OR 97027
Phone
(503) 659-5515
NPI assigned
Oct 29, 2014
Last updated
Jan 26, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2018

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

Authorized official

Name
Amanda Robertson
Title
Contract and Credentialing
Phone
(503) 233-5405

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X NU Primary

Addresses

Primary practice location

890 SE 82ND
Gladstone, OR 97027

Mailing address

PO Box 82819
Portland, OR 97282
Phone (503) 233-5405

Other identifiers 1

IdentifierTypeStateIssuer
164936MedicaidOR

National Provider Directory

National Provider Directory
Tax ID family
Western Pysch Cnslg S18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1414540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516924800000",
    "number": "1295130532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 82819",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97282",
            "telephone_number": "503-233-5405",
            "fax_number": "503-233-2694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 SE 82ND",
            "city": "GLADSTONE",
            "state": "OR",
            "postal_code": "97027",
            "telephone_number": "503-659-5515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN PSYCHOLOGICAL AND COUNSELING SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-29",
        "last_updated": "2018-01-26",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "CONTRACT AND CREDENTIALING",
        "authorized_official_telephone_number": "503-233-5405"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164936",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gladstone, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2018; 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.