NPIMap

Organization Active NPI

Eastside Child and Family Therapy, LLC

  • Mental Health Counselor
  • Gresham, OR
National Provider Identifier
1366189797
Registry record updated May 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
EASTSIDE CHILD AND FAMILY THERAPY, LLC
Practice address
320 N Main Ave Ste 201a
Gresham, OR 97030-7242
Phone
(503) 389-0542
Fax
(503) 405-4239
NPI assigned
May 17, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2022

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

Authorized official

Name
Sarah Manlupig, LPCNPI 1093190787
Title
Owner/Counselor
Phone
(503) 389-0542

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

320 N Main Ave Ste 201a
Gresham, OR 97030-7242

Mailing address

320 N Main Ave Ste 201a
Gresham, OR 97030-7242
Phone (503) 389-0542

National Provider Directory

National Provider Directory

Locations

320 N Main Ave
Ste 201A
Gresham, OR 97030
Phone (503) 208-5288

Practitioners & affiliated clinicians

Practitioners 5

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": "1652745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652745600000",
    "number": "1366189797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 N MAIN AVE STE 201A",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970307242",
            "telephone_number": "503-389-0542",
            "fax_number": "503-405-4239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 N MAIN AVE STE 201A",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970307242",
            "telephone_number": "503-389-0542",
            "fax_number": "503-405-4239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTSIDE CHILD AND FAMILY THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-17",
        "last_updated": "2022-05-17",
        "certification_date": "2022-05-17",
        "status": "A",
        "authorized_official_last_name": "MANLUPIG",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "OWNER/COUNSELOR",
        "authorized_official_telephone_number": "503-389-0542",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2022; 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.