Lakeside Serenity Psychiatry, LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

LAKESIDE SERENITY PSYCHIATRY, LLC

Practice address

5441 S.Maccadan Ave 8160
Portland, OR 97239

Phone

(917) 265-9614

NPI assigned

Dec 30, 2025

Last updated

Dec 30, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dallas Upchurch, PMHNP-BCNPI 1013551233

Title

Owner

Phone

(917) 265-9614

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dallas Leigh Upchurch, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Temple, TX
  • NPI 1013551233
  NPD Authorized official

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

{
    "created_epoch": "1767052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767052800000",
    "number": "1366308785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 KENDRA DR",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765025878",
            "telephone_number": "917-265-9611",
            "fax_number": "917-265-9614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5441 S.MACCADAN AVE 8160",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97239",
            "telephone_number": "917-265-9614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE SERENITY PSYCHIATRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-30",
        "last_updated": "2025-12-30",
        "certification_date": "2025-12-27",
        "status": "A",
        "authorized_official_last_name": "UPCHURCH",
        "authorized_official_first_name": "DALLAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-265-9614",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dakota Micheal Lake, LCSW
• Dana Michal Lake
• Emily Elizabeth Lake, MA
• Rochelle Jeaness Lake, MA, QMHP
• Violet Lawther Lakeland, FPMHNP-BC
• Lakeview Neurophysiology
• Paul Conrad Lakin, MD
• Riley Lakos, QMHP
• Mallika Lal
• Nicole Autumn Laliberte

• Psychiatry Physician in Portland, OR
• Providers in Portland, OR by specialty
• Psychiatry Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2025; 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.