Psychmed LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1626 Issued in OR

Legal business name

PSYCHMED LLC

Practice address

2354 SE 59TH Ave
Portland, OR 97215-4018

Phone

(503) 516-9308

NPI assigned

Sep 29, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Patrice D Carrello, PHDNPI 1437215712

Title

Clinical Psychologist

Phone

(503) 516-9308

Specialties & licenses 2

Addresses

Practitioners 1

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

• Patrice Deidre Carrello, PH.D.

  • Clinical Psychologist
  • Portland, OR
  • NPI 1437215712
  NPD (past) Authorized official

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

{
    "created_epoch": "1285718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285718400000",
    "number": "1477862142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12745",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973090745",
            "telephone_number": "503-516-9308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2354 SE 59TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972154018",
            "telephone_number": "503-516-9308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHMED LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-29",
        "last_updated": "2010-09-29",
        "status": "A",
        "authorized_official_last_name": "CARRELLO",
        "authorized_official_first_name": "PATRICE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "503-516-9308",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "1626",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryle W Przybylowicz, MD
• Monica Psomas, LMT
• Psyche in Soprano
• Psychiatric Care PC
• Psychmatters LLC
• Psychological Health Services, P.C.
• Psychological Services Connection LLC
• Psychpod LLC
• Cara Pszczolkowski
• PT & OT of Oregon, LLC

• 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 Sep 29, 2010; 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.