Alysse Lynette Borba, CRMII, PSS, CRGM

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

License

25-QMHA-I-005000 Issued in OR

Practice address

248 Mace Rd
Medford, OR 97501-1280

Phone

(971) 219-3314

NPI assigned

Jan 14, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Alysse Lynette Kelly Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/phoenixcounseling/r4/

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.

• Elderly and Disabled Services

  • Mental Illness Community Based Residential Treatment Facility
  • Medford, OR
  • NPI 1336889211
  NPD (past)
• Elderly and Disabled Services

  • Mental Illness Community Based Residential Treatment Facility
  • Medford, OR
  • NPI 1932714581
  NPD (past)
• Phoenix Counseling Center, Inc.

  • Community/Behavioral Health Agency
  • Phoenix, OR
  • NPI 1376716571
  NPD (past)

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

{
    "created_epoch": "1578960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785196800000",
    "number": "1386284685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "248 MACE RD",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975011280",
            "telephone_number": "458-225-9358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "248 MACE RD",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975011280",
            "telephone_number": "971-219-3314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORBA",
        "first_name": "ALYSSE",
        "middle_name": "LYNETTE",
        "credential": "CRMII, PSS, CRGM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-14",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OR",
            "license": "25-QMHA-I-005000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALYSSE",
            "last_name": "KELLY",
            "middle_name": "LYNETTE",
            "credential": "CRMII, PSS, CRGM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amy S Boone, L.M.T., C.E.I.M.
• Monica Boone
• James Booth, MD
• Mitchell Bryan Booth, DPM
• Tiana Boozer, CADC-R
• Anne Meredith Bordelon
• Hal L Borg, DMD
• Kristin Marie Borg
• Raven Michala Borgilt, L.M.T.
• Maribell Eduwiges Borjon

• Case Manager/Care Coordinator in Medford, OR
• Providers in Medford, OR by specialty
• Case Manager/Care Coordinator in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2026; 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.