Active NPI
Latrece Gaither, M.A.
- Marriage & Family Therapist
- Gresham, OR
National Provider Identifier
1316295587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- T1531
- Practice address
- 510 NE Roberts Ave Ste 200
Gresham, OR 97030-7484 - Phone
- (971) 236-2728
- Fax
- (855) 719-2524
- NPI assigned
- Aug 20, 2012
- Last updated
- Oct 23, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | C5156 | OR | |
| Marriage & Family Therapist | 106H00000X | T1531 | OR | Primary |
Addresses
Primary practice location
510 NE Roberts Ave Ste 200
Gresham, OR 97030-7484
Mailing address
PO Box 214
Fairview, OR 97024-0214
Phone (971) 236-2728
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C5156 | OR | MD | Mental Health Counselor |
| T1531 | OR | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Latrece Gaither, LLC | Mental Health | Current | Accepting new patients |
| Sankofa Counseling, LLC | Mental Health | Past | Accepting new patients |
Locations
510 NE Roberts Ave
Ste 200
Gresham, OR 97030
Phone (503) 799-8819
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Mental Health Counselor
- Gresham, OR
- NPI 1356065502
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1345420800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698019200000",
"number": "1316295587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 214",
"city": "FAIRVIEW",
"state": "OR",
"postal_code": "970240214",
"telephone_number": "971-236-2728"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "510 NE ROBERTS AVE STE 200",
"city": "GRESHAM",
"state": "OR",
"postal_code": "970307484",
"telephone_number": "971-236-2728",
"fax_number": "855-719-2524"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAITHER",
"first_name": "LATRECE",
"credential": "M.A.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-08-20",
"last_updated": "2023-10-23",
"certification_date": "2023-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": "C5156",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "OR",
"license": "T1531",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gresham, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.