Active NPI
Jacqueline Bension, MA, LMFTA
- Mental Health Counselor
- Portland, OR
National Provider Identifier
1396149852
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MG60612096
- Practice address
- 1705 SE 122ND Ave
Portland, OR 97233 - Phone
- (503) 310-4116
- NPI assigned
- Oct 13, 2014
- Last updated
- Aug 28, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | NU | ||
| Mental Health Counselor | 101YM0800X | MG60612096 | WA | Primary |
Addresses
Primary practice location
1705 SE 122ND Ave
Portland, OR 97233
Mailing address
4740 SE 29TH Ave
Portland, OR 97202-3628
Phone (818) 404-8407
Other practice location 1
1904 SE Division St
Portland, OR 97202-1146
Phone (503) 517-8663
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MG60612096 | WA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Catholic Community Services of Western Washington | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Portland, OR
- NPI 1699222547
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1413158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1535414400000",
"number": "1396149852",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4740 SE 29TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972023628",
"telephone_number": "818-404-8407"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1705 SE 122ND AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97233",
"telephone_number": "503-310-4116"
}
],
"practiceLocations": [
{
"address_1": "1904 SE Division St",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972021146",
"country_code": "US",
"telephone_number": "503-517-8663",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BENSION",
"first_name": "JACQUELINE",
"credential": "MA, LMFTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-10-13",
"last_updated": "2018-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "MG60612096",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.