Awakened Heart PDX, LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

T1051 Issued in OR

Legal business name

AWAKENED HEART PDX, LLC

Practice address

1306 NW Hoyt St Ste 407
Portland, OR 97209-2787

Phone

(971) 407-3930

NPI assigned

Aug 25, 2017

Organization subpart

Yes

Parent organization

AWAKENED HEART PDX, LLCAs reported in NPPES

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

Authorized official

Name

Ann Marie McHenry, LMFTNPI 1477854750

Title

Owner, Marriage & Family Therapist

Phone

(971) 407-3930

Specialties & licenses 1

Addresses

Other identifiers 3

Part of

Awakened Heart PDX LLC

Locations

Practitioners 4

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

• Ann Marie McHenry, MA, LMFT

  • Marriage & Family Therapist
  • Portland, OR
  • NPI 1477854750
  NPD Authorized official
• Elise Helms, MS

  • Professional Counselor
  • Portland, OR
  • NPI 1275252611
  NPD (past)
• Kelsey Leigh Stewart

  • Marriage & Family Therapist
  • Portland, OR
  • NPI 1134878945
  NPD (past)
• Faith Swords

  • Clinical Social Worker
  • Portland, OR
  • NPI 1093332132
  NPD (past)

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

{
    "created_epoch": "1503619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646956800000",
    "number": "1467979914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1306 NW HOYT ST STE 407",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972092787",
            "telephone_number": "971-407-3930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1306 NW HOYT ST STE 407",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972092787",
            "telephone_number": "971-407-3930"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1306 NW Hoyt St Ste 306",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972092786",
            "country_code": "US",
            "telephone_number": "971-407-3930",
            "fax_number": "866-813-3263",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3115 NE Sandy Blvd Ste 225",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972322777",
            "country_code": "US",
            "telephone_number": "971-407-3930",
            "fax_number": "866-813-3263",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AWAKENED HEART PDX, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AWAKENED HEART PDX, LLC",
        "enumeration_date": "2017-08-25",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A",
        "authorized_official_last_name": "MCHENRY",
        "authorized_official_first_name": "ANN MARIE",
        "authorized_official_title_or_position": "OWNER, MARRIAGE & FAMILY THERAPIST",
        "authorized_official_telephone_number": "971-407-3930",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "OR",
            "license": "T1051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE 1",
            "identifier": "1477854750",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1609295682",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE 1",
            "identifier": "1134628571",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alisa Avvakumova
• Omran Awada
• Sami Awadh, MD
• Awake Together
• Awaken Natural Medicine Inc
• Awakening Lotus Health Care, Inc.
• Awakening Your Authenticity LLC
• Awakenings Bybee Center LLC
• Zachary Scott Aweidah
• Aisha Awo

• Adult Mental Health Clinic/Center in Portland, OR
• Providers in Portland, OR by specialty
• Adult Mental Health Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.