Individual provider Active NPI

Alli Marie Santa, MA

  • Professional Counselor
  • Beaverton, OR
National Provider Identifier
1417769720
Registry record updated Feb 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
C10121 Issued in OR
Practice address
16269 SW Medallion LN
Beaverton, OR 97007-7873
Phone
(503) 440-6959
NPI assigned
Jan 23, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X C10121 OR Primary

Addresses

Primary practice location

16269 SW Medallion LN
Beaverton, OR 97007-7873

Mailing address

16269 SW Medallion LN
Beaverton, OR 97007-7873
Phone (503) 440-6959

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260420002557 OR Practitioner - Mental Health Counselor 3072089762 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thriveworks Clinical - Oregon LLCGroup PAC ID 1254715006, 7 clinicians

Practice addresses (Care Compare)

9735 SW Shady LN
Suite 304
Tigard, OR 97223-5481
Phone (855) 284-7483

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
C10121ORMDProfessional Counselor

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1737590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770336000000",
    "number": "1417769720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16269 SW MEDALLION LN",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970077873",
            "telephone_number": "503-440-6959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16269 SW MEDALLION LN",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970077873",
            "telephone_number": "503-440-6959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTA",
        "first_name": "ALLI",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-23",
        "last_updated": "2026-02-06",
        "certification_date": "2026-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C10121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

Verify at the official NPI Registry.