NPIMap

Organization Active NPI

Lifeworks NW

  • Mental Health Counselor
  • Portland, OR
National Provider Identifier
1467408013
Registry record updated Mar 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
LIFEWORKS NW
Practice address
5415 SW Westgate Drive
Portland, OR 97221-2406
Phone
(503) 645-3581
Fax
(503) 629-8517
NPI assigned
May 25, 2006
Last updated
Mar 9, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2022

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

Authorized official

Name
Mary Monnat, MA,LPC, CADC III
Title
Ceo
Phone
(503) 645-3581

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

5415 SW Westgate Drive
Portland, OR 97221-2406

Mailing address

5415 SW Westgate Drive
Portland, OR 97221-2406
Phone (503) 645-3581

Other identifiers 1

IdentifierTypeStateIssuer
197640MedicaidOR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040323000387 OR Part B Supplier - Clinic/Group Practice 1850282575 Receives reassigned benefits from 47 practitioners
Practice locations: Tigard, OR; Gresham, OR; Portland, OR; Milwaukie, OR; Hillsboro, OR; Beaverton, OR

National Provider Directory

National Provider Directory
Tax ID family
Tualatin Vly Ment HLTH6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2911 Marine Dr
Ste B
Astoria, OR 97103
Phone (503) 338-6990

14255 SW Brigadoon Ct
Beaverton, OR 97005
Phone (503) 641-1475

3900 SW Murray Blvd
Ste 100
Beaverton, OR 97005
Phone (503) 352-0045

1340 E Main St
Hillsboro, OR 97123
Phone (503) 597-6089

5240 NE Elam Young Pkwy
Ste 700
Hillsboro, OR 97124

17000 SE McLoughlin Blvd
Milwaukie, OR 97267
Phone (503) 594-1772

10638 NE Glisan St
Portland, OR 97220
Phone (503) 254-6804

10714 NE Glisan St
Portland, OR 97220
Phone (503) 254-2453

1245 SE 122nd Ave
Portland, OR 97233
Phone (503) 290-8816

14600 NW Cornell Rd
Portland, OR 97229

17214 SE Division St
Portland, OR 97236
Phone (503) 761-5272

3716 NE Mlk Jr Blvd
Portland, OR 97212
Phone (503) 228-8066

4105 SE International Way
Ste 501
Portland, OR 97222
Phone (503) 496-3201

4925 N Albina Ave
Portland, OR 97217
Phone (503) 548-4922

506 SW 6th Ave
Ste 905
Portland, OR 97204
Phone (503) 223-5525

5415 SW Westgate Dr
Ste 100
Portland, OR 97221

8425 N Lombard St
Portland, OR 97203
Phone (503) 283-4776

8770 SW Scoffins St
Tigard, OR 97223
Phone (503) 684-1424

Practitioners & affiliated clinicians

Practitioners 237

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 237

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646784000000",
    "number": "1467408013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5415 SW WESTGATE DRIVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972212406",
            "telephone_number": "503-645-3581",
            "fax_number": "503-629-8517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5415 SW WESTGATE DRIVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972212406",
            "telephone_number": "503-645-3581",
            "fax_number": "503-629-8517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEWORKS NW",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-09",
        "status": "A",
        "authorized_official_last_name": "MONNAT",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "503-645-3581",
        "authorized_official_credential": "MA,LPC, CADC III"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "197640",
            "state": "OR"
        }
    ],
    "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 Mar 9, 2022; 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.