NPIMap

Organization Active NPI

Youth Villages

  • Mental Health Counselor
  • Oregon City, OR
National Provider Identifier
1356757108
Registry record updated Jul 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
YOUTH VILLAGES
Practice address
15544 S Clackamas River Dr
Oregon City, OR 97045-9490
Phone
(503) 974-5816
Fax
(503) 607-0211
NPI assigned
Jul 1, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2014

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

Authorized official

Name
Berenice Mendoza Cabello, MSW,QMHP
Title
Bilingual Intercept Specialist
Phone
(503) 974-5816

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

15544 S Clackamas River Dr
Oregon City, OR 97045-9490

Mailing address

15544 S Clackamas River Dr
Oregon City, OR 97045-9490
Phone (503) 974-5816

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Psychiatric residential treatment facility certification: CCN 38L006

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
YOUTH VILLAGES
Certification status
Active
Provider type (POS)
Psychiatric residential treatment facility
Participating since
Mar 9, 2005
Last certification
Mar 9, 2005
Beds
10
Ownership / control type
Non-profit – corporation
Facility address
15544 S Clackamas River Drive
Oregon City, OR 97045

National Provider Directory

National Provider Directory

Locations

15544 S Clackamas River Rd
Oregon City, OR 97045
Phone (503) 607-0520

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1404172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404172800000",
    "number": "1356757108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15544 S CLACKAMAS RIVER DR",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970459490",
            "telephone_number": "503-974-5816",
            "fax_number": "503-607-0211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15544 S CLACKAMAS RIVER DR",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970459490",
            "telephone_number": "503-974-5816",
            "fax_number": "503-607-0211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUTH VILLAGES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-01",
        "last_updated": "2014-07-01",
        "status": "A",
        "authorized_official_last_name": "MENDOZA CABELLO",
        "authorized_official_first_name": "BERENICE",
        "authorized_official_title_or_position": "BILINGUAL INTERCEPT SPECIALIST",
        "authorized_official_telephone_number": "503-974-5816",
        "authorized_official_credential": "MSW,QMHP"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oregon City, OR

Sources for this page

Verify at the official NPI Registry.