Active NPI
Amy J Nortrom, LPC
- Professional Counselor
- Bend, OR
National Provider Identifier
1336491604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- C2134
- Practice address
- 63360 NW Britta Street
BLDG 1
Bend, OR 97703 - Phone
- (541) 316-0269
- NPI assigned
- Oct 10, 2012
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | C2134 | OR | Primary |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 22-06-30037 | OR |
Addresses
Primary practice location
63360 NW Britta Street
BLDG 1
Bend, OR 97703
Mailing address
63360 Britta St Ste 1
Bend, OR 97701-9475
Phone (541) 316-0269
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C2134 | OR | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1349827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681344000000",
"number": "1336491604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "63360 BRITTA ST STE 1",
"city": "BEND",
"state": "OR",
"postal_code": "977019475",
"telephone_number": "541-316-0269"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "63360 NW BRITTA STREET",
"address_2": "BLDG 1",
"city": "BEND",
"state": "OR",
"postal_code": "97703",
"telephone_number": "541-316-0269"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NORTROM",
"first_name": "AMY",
"middle_name": "J",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-10-10",
"last_updated": "2023-04-13",
"certification_date": "2023-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OR",
"license": "C2134",
"primary": true
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OR",
"license": "22-06-30037",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 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.