Individual provider Active NPI

Kudzai Chifamba

  • Mental Health Counselor
  • Beaverton, OR
National Provider Identifier
1417685769
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
R9491 Issued in OR
Practice address
6800 SW 105TH Ave Ste 101
Beaverton, OR 97008-5488
Phone
(971) 200-1966
Fax
(971) 754-4141
NPI assigned
Aug 12, 2022
Last updated
Sep 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X R9491 OR Primary

Addresses

Primary practice location

6800 SW 105TH Ave Ste 101
Beaverton, OR 97008-5488

Mailing address

6800 SW 105TH Ave Ste 101
Beaverton, OR 97008-5488
Phone (971) 200-1966

Other practice location 1

700 N Deborah Rd Ste 270
Newberg, OR 97132-2270
Phone (971) 200-1966

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

LicenseStateTypeSpecialty
R9491ORMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Higher Ground Counseling Inc Counselor CurrentSince Apr 21, 2024 Accepting new patients

Locations

6800 SW 105th Ave
Ste 101
Beaverton, OR 97008
Phone (971) 200-1966

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.

NPI Registry JSON

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

{
    "created_epoch": "1660262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1417685769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 SW 105TH AVE STE 101",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970085488",
            "telephone_number": "971-200-1966",
            "fax_number": "971-754-4141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6800 SW 105TH AVE STE 101",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970085488",
            "telephone_number": "971-200-1966",
            "fax_number": "971-754-4141"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 N Deborah Rd Ste 270",
            "address_purpose": "LOCATION",
            "city": "Newberg",
            "state": "OR",
            "postal_code": "971322270",
            "country_code": "US",
            "telephone_number": "971-200-1966",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHIFAMBA",
        "first_name": "KUDZAI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-12",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "R9491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.

Verify at the official NPI Registry.