Active NPI
Andrea Elizabeth Benach
- Professional Counselor
- Tigard, OR
National Provider Identifier
1376276121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- C3909
- Practice address
- 9900 SW Greenburg Rd Ste 235
Tigard, OR 97223-5473 - Phone
- (503) 308-8016
- NPI assigned
- Jul 7, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | C3909 | OR | Primary |
Addresses
Primary practice location
9900 SW Greenburg Rd Ste 235
Tigard, OR 97223-5473
Mailing address
9900 SW Greenburg Rd Ste 235
Tigard, OR 97223-5473
Phone (503) 308-8016
Other names 1
- Andrea Elizabeth Carlson
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C3909 | OR | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Second Growth Counseling LLC | Professional | Past | Accepting new patients |
Organizations & group practices 1
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": "1657152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724371200000",
"number": "1376276121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9900 SW GREENBURG RD STE 235",
"city": "TIGARD",
"state": "OR",
"postal_code": "972235473",
"telephone_number": "503-308-8016"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9900 SW GREENBURG RD STE 235",
"city": "TIGARD",
"state": "OR",
"postal_code": "972235473",
"telephone_number": "503-308-8016"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENACH",
"first_name": "ANDREA",
"middle_name": "ELIZABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-07",
"last_updated": "2024-08-23",
"certification_date": "2024-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OR",
"license": "C3909",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ANDREA",
"last_name": "CARLSON",
"middle_name": "ELIZABETH",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Tigard, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.