Marina Isabella Nelson, MC, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C1934 Issued in OR

Practice address

10200 SW Eastridge St Ste 101
Portland, OR 97225-5031

Phone

(503) 201-7502

Fax

(503) 292-2980

NPI assigned

Aug 22, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Marie Hayden Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1187740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572652800000",
    "number": "1336332337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10200 SW EASTRIDGE ST STE 101",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255031",
            "telephone_number": "503-201-7502",
            "fax_number": "503-292-2980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10200 SW EASTRIDGE ST STE 101",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255031",
            "telephone_number": "503-201-7502",
            "fax_number": "503-292-2980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "MARINA",
        "middle_name": "ISABELLA",
        "name_prefix": "Ms.",
        "credential": "MC, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-22",
        "last_updated": "2019-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LPC11117",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C1934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIE",
            "last_name": "HAYDEN",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lindsay Rae Nelson, BCBA
• Lindsey S Nelson, N.D.
• Lisa Nelson
• Lisa Marie Nelson
• Maria Joy Nelson, M.D., M.C.R.
• Martha Nelson, MD
• Mary Kaitlyn Nelson
• Matthew F Nelson
• Miki K Nelson, MD
• Miranda Sofe Nelson, CSWA

• Mental Health Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2019; 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.