Heal Thrive Grow Behavioral Health, Inc.

Primary specialty

Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X

Legal business name

HEAL THRIVE GROW BEHAVIORAL HEALTH, INC.

Practice address

5200 SW Macadam Ave Ste 155
Portland, OR 97239-3833

Phone

(503) 290-3261

Fax

(503) 231-8153

NPI assigned

Jun 25, 2015

Organization subpart

Yes

Parent organization

PORTLAND DBT INSTITUTE, INC.As reported in NPPES

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

Authorized official

Name

Loren Wampler

Title

Business Operations

Phone

(503) 290-3290

Specialties & licenses 5

Addresses

Other names 1

• Portland Evidence Based Psychotherapy Clinic, Inc. Former legal business name

Part of

Portland DBT Institute Inc

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Portland DBT Institute, Inc.

  • Cognitive & Behavioral Psychologist
  • Portland, OR
  • NPI 1073853966
  NPPES parent name

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

{
    "created_epoch": "1435190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481068800000",
    "number": "1376925339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 SW MACADAM AVE STE 580",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393837",
            "telephone_number": "503-290-3261",
            "fax_number": "503-231-8153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 SW MACADAM AVE STE 155",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393833",
            "telephone_number": "503-290-3261",
            "fax_number": "503-231-8153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEAL THRIVE GROW BEHAVIORAL HEALTH, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PORTLAND DBT INSTITUTE, INC.",
        "enumeration_date": "2015-06-25",
        "last_updated": "2016-12-07",
        "status": "A",
        "authorized_official_last_name": "WAMPLER",
        "authorized_official_first_name": "LOREN",
        "authorized_official_title_or_position": "BUSINESS OPERATIONS",
        "authorized_official_telephone_number": "503-290-3290"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Group Psychotherapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Portland Evidence Based Psychotherapy Clinic, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Cognitive & Behavioral Psychologist in Portland, OR
• Providers in Portland, OR by specialty
• Cognitive & Behavioral Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2016; 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.