NPIMap

Organization Active NPI

Psychology & Wellness Group PDX LLC

  • Professional Counselor
  • Tigard, OR
National Provider Identifier
1306315965
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
PSYCHOLOGY & WELLNESS GROUP PDX LLC
Practice address
7555 SW Hermoso Way Ste 120
Tigard, OR 97223-8684
Phone
(503) 345-3260
Fax
(503) 345-3052
NPI assigned
Nov 13, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2023

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

Authorized official

Name
Stephanie Snow, MS, LPCNPI 1306988928
Title
Owner
Phone
(503) 345-3260

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

7555 SW Hermoso Way Ste 120
Tigard, OR 97223-8684

Mailing address

7555 SW Hermoso Way Ste 120
Tigard, OR 97223-8684
Phone (503) 345-3260

Other identifiers 1

IdentifierTypeStateIssuer
500656380MedicaidOR

Other names 1

  • Psychology & Wellness Group PDX Doing business as

National Provider Directory

National Provider Directory

Locations

14511 Westlake Dr
Ste 250
Lake Oswego, OR 97035
Phone (503) 345-3260

14523 Westlake Dr
Ste 19
Lake Oswego, OR 97035

7555 SW Hermoso Way
Ste 120
Tigard, OR 97223
Phone (503) 345-3260

Practitioners & affiliated clinicians

Practitioners 11

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

NPI Registry JSON

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

{
    "created_epoch": "1542067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692144000000",
    "number": "1306315965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7555 SW HERMOSO WAY STE 120",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972238684",
            "telephone_number": "503-345-3260",
            "fax_number": "503-345-3052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7555 SW HERMOSO WAY STE 120",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972238684",
            "telephone_number": "503-345-3260",
            "fax_number": "503-345-3052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGY & WELLNESS GROUP PDX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-13",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A",
        "authorized_official_last_name": "SNOW",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-345-3260",
        "authorized_official_credential": "MS, LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500656380",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Psychology & Wellness Group PDX",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tigard, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; 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.