Individual provider Active NPI

Susan Ujvary, MS

  • Mental Health Counselor
  • Portland, OR
National Provider Identifier
1336537943
Registry record updated Jan 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
R2557 Issued in OR
Practice address
3800 NE Sandy Blvd
#208
Portland, OR 97232-1881
Phone
(360) 693-7349
Fax
(503) 296-5758
NPI assigned
Jan 5, 2015
Last updated
Jan 5, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X R2557 OR Primary

Addresses

Primary practice location

3800 NE Sandy Blvd
#208
Portland, OR 97232-1881

Mailing address

3800 NE Sandy Blvd
#208
Portland, OR 97232-1881
Phone (360) 693-7349

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 Science

State licenses

LicenseStateTypeSpecialty
R2557ORMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Gender and Sex Therapy Clinic PLLC Mental Health Current Accepting new patients

Locations

1525 NE Weidler St
Ste 101
Portland, OR 97232
Phone (503) 227-3912

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1420416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420416000000",
    "number": "1336537943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 NE SANDY BLVD",
            "address_2": "#208",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321881",
            "telephone_number": "360-693-7349",
            "fax_number": "503-296-5758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 NE SANDY BLVD",
            "address_2": "#208",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321881",
            "telephone_number": "360-693-7349",
            "fax_number": "503-296-5758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UJVARY",
        "first_name": "SUSAN",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-05",
        "last_updated": "2015-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "R2557",
            "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 Jan 5, 2015; 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.