Organization Active NPI

Corporate Consulting Group, Inc

  • Psychologist
  • Portland, OR
National Provider Identifier
1427585546
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
736 Issued in OR
Legal business name
CORPORATE CONSULTING GROUP, INC
Practice address
11905 SW 60TH Ave
Portland, OR 97219-7005
Phone
(503) 226-0828
Fax
(503) 892-8281
NPI assigned
May 19, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Authorized official

Name
Dr. Birgitta Von Schlumperger, PHDNPI 1578554671
Title
Ceo/President/Owner
Phone
(503) 226-0828

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 736 OR Primary

Addresses

Primary practice location

11905 SW 60TH Ave
Portland, OR 97219-7005

Mailing address

11905 SW 60TH Ave
Portland, OR 97219-7005
Phone (150) 322-6082

Other identifiers 1

IdentifierTypeStateIssuer
1578554671OtherINDIVIDUAL NPI NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181009002067 OR Part B Supplier - Clinic/Group Practice 8123370780 Receives reassigned benefits from 1 practitioner
Practice locations: Nehalem, OR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1495152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1427585546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11905 SW 60TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972197005",
            "telephone_number": "150-322-6082",
            "fax_number": "503-892-8281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11905 SW 60TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972197005",
            "telephone_number": "503-226-0828",
            "fax_number": "503-892-8281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORPORATE CONSULTING GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-19",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "VON SCHLUMPERGER",
        "authorized_official_first_name": "BIRGITTA",
        "authorized_official_title_or_position": "CEO/PRESIDENT/OWNER",
        "authorized_official_telephone_number": "503-226-0828",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "OR",
            "license": "736",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI NUMBER",
            "identifier": "1578554671",
            "state": null
        }
    ],
    "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 Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.