NPIMap

Organization Active NPI

Brightlight Oasis Psychiatry and Counseling PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Arlington, TX
National Provider Identifier
1467106294
Registry record updated Apr 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
BRIGHTLIGHT OASIS PSYCHIATRY AND COUNSELING PLLC
Practice address
2000 E Lamar Blvd Ste 600
Arlington, TX 76006-7361
Phone
(503) 662-9385
Fax
(316) 661-1877
NPI assigned
Feb 10, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2023

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

Authorized official

Name
Ayisha Sanda, PMHNPNPI 1659042844
Title
Provider
Phone
(503) 662-9385

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
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

2000 E Lamar Blvd Ste 600
Arlington, TX 76006-7361

Mailing address

547 Breton Dr
Grand Prairie, TX 75052-2525
Phone (503) 662-9385

Other practice location 1

1050 SW 6th Ave Ste 1100
Portland, OR 97204-1153
Phone (503) 662-9385

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, OR, AZ3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20220928001784 TX Part B Supplier - Clinic/Group Practice 1254717242 Receives reassigned benefits from 2 practitioners
Practice locations: Arlington, TX
O20230705000336 OR Part B Supplier - Clinic/Group Practice 1254717242 Receives reassigned benefits from 2 practitioners
Practice locations: Portland, OR
O20230707003301 AZ Part B Supplier - Clinic/Group Practice 1254717242 Receives reassigned benefits from 1 practitioner
Practice locations: Phoenix, AZ

National Provider Directory

National Provider Directory

Locations

3330 Matlock Rd
Ste 202B
Arlington, TX 76015
Phone (503) 662-9385

Practitioners & affiliated clinicians

Practitioners 3

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": "1644451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682640000000",
    "number": "1467106294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "547 BRETON DR",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750522525",
            "telephone_number": "503-662-9385",
            "fax_number": "316-661-1877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 E LAMAR BLVD STE 600",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760067361",
            "telephone_number": "503-662-9385",
            "fax_number": "316-661-1877"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1050 SW 6th Ave Ste 1100",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972041153",
            "country_code": "US",
            "telephone_number": "503-662-9385",
            "fax_number": "316-661-1877",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BRIGHTLIGHT OASIS PSYCHIATRY AND COUNSELING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-10",
        "last_updated": "2023-04-28",
        "certification_date": "2023-04-28",
        "status": "A",
        "authorized_official_last_name": "SANDA",
        "authorized_official_first_name": "AYISHA",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "503-662-9385",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2023; 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.