Erica S.N. Tan, LCP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2071 Issued in OR

Practice address

5200 SW Macadam Ave
Suite 580
Portland, OR 97239-6103

Phone

(503) 290-3266

Fax

(503) 231-8153

NPI assigned

Jul 5, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Clinical Psychologist

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Portland DBT Institute IncGroup PAC ID 7911141742, 28 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Portland DBT Institute, Inc.

  • Cognitive & Behavioral Psychologist
  • Portland, OR
  • NPI 1073853966
  Medicare reassignment Care Compare group
• Eden Counseling Center

  • Mental Health Counselor
  • Norfolk, VA
  • NPI 1801906144
  NPD (past)
• Genesis Counseling Center, Inc.

  • Professional Counselor
  • Hampton, VA
  • NPI 1164451399

  Clinical

  NPD (past)

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488153600000",
    "number": "1447281977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 SW MACADAM AVE",
            "address_2": "SUITE 580",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972396103",
            "telephone_number": "503-290-3266",
            "fax_number": "503-231-8153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 SW MACADAM AVE",
            "address_2": "SUITE 580",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972396103",
            "telephone_number": "503-290-3266",
            "fax_number": "503-231-8153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "ERICA",
        "middle_name": "S.N.",
        "name_prefix": "Ms.",
        "credential": "LCP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2017-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "2071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010232139",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edith Tamay Mena
• Bette Susan Tambellini
• Danielle Elisse Forster Tamiesie, QMHA
• Selba Tamrakar
• Tan Oak Wellness Services
• Hanny Augustina Tan, MD
• Hao Tan
• Hpyoe Thida Thein Tan
• Jo-Anna Tan, DDS
• Matthew Tan, RN

• Clinical Psychologist in Portland, OR
• Providers in Portland, OR by specialty
• Clinical Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.