NPIMap

Organization Active NPI

Copper Valley Integrated Health LLC

  • Mental Health Counselor
  • Portland, OR
National Provider Identifier
1336002799
Registry record updated Dec 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
COPPER VALLEY INTEGRATED HEALTH LLC
Practice address
830 NE Holladay St
Portland, OR 97232-2104
Phone
(207) 409-4027
NPI assigned
Dec 3, 2025
Last updated
Dec 3, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2025

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

Authorized official

Name
Luc-Armand Ningumirize
Title
Manager
Phone
(207) 409-4027

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

830 NE Holladay St
Portland, OR 97232-2104

Mailing address

830 NE Holladay St
Portland, OR 97232-2104

National Provider Directory

National Provider Directory
Tax ID family
Copper Valley Integrated Health LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1764720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764720000000",
    "number": "1336002799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 NE HOLLADAY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 NE HOLLADAY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322104",
            "telephone_number": "207-409-4027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COPPER VALLEY INTEGRATED HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-03",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "status": "A",
        "authorized_official_last_name": "NINGUMIRIZE",
        "authorized_official_first_name": "LUC-ARMAND",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "207-409-4027"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "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 Dec 3, 2025; 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.