Individual provider Active NPI

Lisa Motley

  • Mental Health Counselor
  • Dallas, OR
National Provider Identifier
1356873384
Registry record updated Nov 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
182 SW Academy St
Dallas, OR 97338-1996
Phone
(503) 623-9289
NPI assigned
Mar 29, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YA0400X T-16-026 OR

Addresses

Primary practice location

182 SW Academy St
Dallas, OR 97338-1996

Mailing address

1773 Evergreen Ave NE
Salem, OR 97301-8184
Phone (503) 949-4391

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211123000073 OR Practitioner - Clinical Social Worker 6305235847 Reassigns benefits to 1 organization
Practice locations: Salem, OR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Salem Psychiatric Associates PCGroup PAC ID 6002702420, 24 clinicians

Practice addresses (Care Compare)

821 Saginaw St S
Salem, OR 97302-4121
Phone (503) 433-3556

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
T-16-026ORMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Holistic Integrative Counseling Single Specialty CurrentSince May 12, 2024 Accepting new patients

Locations

821 Saginaw St S
Salem, OR 97302
Phone (503) 362-1999

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1490745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509494400000",
    "number": "1356873384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1773 EVERGREEN AVE NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973018184",
            "telephone_number": "503-949-4391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "182 SW ACADEMY ST",
            "city": "DALLAS",
            "state": "OR",
            "postal_code": "973381996",
            "telephone_number": "503-623-9289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOTLEY",
        "first_name": "LISA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-29",
        "last_updated": "2017-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "T-16-026",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, OR

Sources for this page

Verify at the official NPI Registry.