Individual provider Active NPI

Paul Attengong Nkemontoh

  • Counselor
  • Hillsboro, OR
National Provider Identifier
1376143057
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
3440 E Main St
Hillsboro, OR 97123-7168
Phone
(971) 808-2686
NPI assigned
Oct 30, 2020
Last updated
Nov 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

3440 E Main St
Hillsboro, OR 97123-7168

Mailing address

13550 SW Pommel CT
Beaverton, OR 97008-7230
Phone (503) 680-8277

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address intern@lifedcs.com Direct Life Discovery Counseling Services

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
I20260403002555 OR Practitioner - Mental Health Counselor 4587139878 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO
Pasadena, CA 91110

PO Box
Suite 3395
Portland, OR 97208-3395

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Heartbound Counseling Services Limited Liability Company Current Accepting new patients
Life Discovery Counseling Services PastSince Nov 1, 2020 Accepting new patients

Organizations & group practices 4

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": "1604016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1376143057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13550 SW POMMEL CT",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970087230",
            "telephone_number": "503-680-8277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3440 E MAIN ST",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971237168",
            "telephone_number": "971-808-2686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NKEMONTOH",
        "first_name": "PAUL",
        "middle_name": "ATTENGONG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-30",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "intern@lifedcs.com",
            "affiliation": "Y",
            "endpointDescription": "Email Address",
            "affiliationName": "Life Discovery Counseling Services",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email Address",
            "address_1": "3440 E Main St",
            "city": "Hillsboro",
            "state": "OR",
            "country_code": "US",
            "postal_code": "971237168",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hillsboro, OR

Sources for this page

Verify at the official NPI Registry.