Active NPI
Melissa Tomecek, QMHP
- Mental Health Counselor
- Portland, OR
National Provider Identifier
1407271786
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 1110 SE Alder St Ste 301
Portland, OR 97214-2400 - Phone
- (503) 726-3690
- NPI assigned
- Feb 24, 2014
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
1110 SE Alder St Ste 301
Portland, OR 97214-2400
Mailing address
1110 SE Alder St Ste 301
Portland, OR 97214-2400
Phone (503) 984-7920
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 390200000X-STUDENT | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 16, 2025 through Jan 16, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1393200000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610409600000",
"number": "1407271786",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1110 SE ALDER ST STE 301",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972142400",
"telephone_number": "503-984-7920"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1110 SE ALDER ST STE 301",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972142400",
"telephone_number": "503-726-3690"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TOMECEK",
"first_name": "MELISSA",
"credential": "QMHP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-02-24",
"last_updated": "2021-01-12",
"certification_date": "2021-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "390200000X-STUDENT",
"state": "OR"
}
],
"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 Jan 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.