Active NPI
Alyssa Brin, LPC, CN
- Professional Counselor
- Portland, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- C7809
- Practice address
- 12636 SE Stark St BLDG J
Portland, OR 97233-1058 - Phone
- (503) 253-4600
- NPI assigned
- Jul 26, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutritionist | 133N00000X | NU60324012 | WA | |
| Professional Counselor | 101YP2500X | C7809 | OR | Primary |
Addresses
Primary practice location
12636 SE Stark St BLDG J
Portland, OR 97233-1058
Mailing address
12636 SE Stark St BLDG J
Portland, OR 97233-1058
Phone (503) 253-4600
Other names 1
- Alyssa C. Pelham
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
12636 SE Stark St Plaza 125 BLDG J
Portland, OR 97233-1058
Phone (503) 253-4600
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C7809 | OR | MD | Mental Health Counselor |
| NU60324012 | WA | MD | Nutritionist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Western Psychological and Counseling Services LLC | Mental Health | Current | Accepting new patients |
| Western Psychological and Counseling Services LLC | Mental Health | Current | Accepting new patients |
Locations
4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392
880 82nd Dr
Gladstone, OR 97027
Phone (503) 626-9494
12636 SE Stark St
Bldg J
Portland, OR 97233
Phone (503) 253-4600
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.
-
- Clinical Psychologist
- Tacoma, WA
- NPI 1912008178
Mental Health, OR
-
- Clinical Psychologist
- Vancouver, WA
- NPI 1629345731
Mental Health
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784505600000",
"number": "1306124276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12636 SE STARK ST BLDG J",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972331058",
"telephone_number": "503-253-4600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12636 SE STARK ST BLDG J",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972331058",
"telephone_number": "503-253-4600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRIN",
"first_name": "ALYSSA",
"credential": "LPC, CN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-07-26",
"last_updated": "2026-07-20",
"certification_date": "2026-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "133N00000X",
"taxonomy_group": "",
"desc": "Nutritionist",
"state": "WA",
"license": "NU60324012",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OR",
"license": "C7809",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ALYSSA",
"last_name": "PELHAM",
"middle_name": "C.",
"credential": "CN, LMHCA, LPC-ASSOC",
"code": "1",
"type": "Former Name"
}
]
}
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 Jul 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.