Nicole Prophet, MS, LPC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

C6307 Issued in OR

Practice address

7227 SE Thorburn St
Portland, OR 97215-1434

Phone

(971) 865-3573

Fax

(971) 999-0908

NPI assigned

Aug 8, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Cole Prophet Other name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Larsen Sanchez Psychology, LLC

  dba Portland Mental Health & Wellness

  • Clinical Psychologist
  • Portland, OR
  • NPI 1588041388
  Medicare reassignment NPD

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

{
    "created_epoch": "1470614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1487108460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7901 SE POWELL BLVD, STE B",
            "address_2": "#111",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972062331",
            "telephone_number": "971-865-3573",
            "fax_number": "971-999-0908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7227 SE THORBURN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972151434",
            "telephone_number": "971-865-3573",
            "fax_number": "971-999-0908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROPHET",
        "first_name": "NICOLE",
        "credential": "MS, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-08",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OR",
            "license": "C6307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COLE",
            "last_name": "PROPHET",
            "credential": "MS, LPC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jordin Whitney Pronath-Holden
• Aumyot Prongdong, MD
• Justin Eric Pronovost
• Bridgette Alexandra Pronozuk
• Nicole Propert
• William Mark Proppe, LMT
• Lois Rebecca Propst, PHD
• Matt Prosa
• Austin Charles Prosch
• Celeste Angelita Prose, BA

• Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.