NPIMap

Individual provider Active NPI

Michael Todd Lichtenberg, M.A., MCFT, QMHP

  • Marriage & Family Therapist
  • Clackamas, OR
National Provider Identifier
1487946133
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
T2049 Issued in OR
Practice address
14839 SE 82ND Dr
Clackamas, OR 97015-7624
Phone
(503) 372-5147
Fax
(503) 650-4302
NPI assigned
May 12, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X
Marriage & Family Therapist 106H00000X T2049 OR Primary

Addresses

Primary practice location

14839 SE 82ND Dr
Clackamas, OR 97015-7624

Mailing address

610 High St
Oregon City, OR 97045-2241
Phone (503) 372-5147

Other practice location 1

2274 SW 2nd St Ste D
McMinnville, OR 97128-5597
Phone (503) 372-5147 ext. 6

Other practice location 2

5291 NE Elam Young Pkwy Ste 160
Hillsboro, OR 97124-7560
Phone (503) 372-5147 ext. 6

Other practice location 3

10130 NE Skidmore St
Portland, OR 97220-3570
Phone (503) 372-5147

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
T2049ORMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Neurotherapeutic Pediatric Therapies Inc Marriage & Family Therapist Past Accepting new patients
Neurotherapeutic Pediatric Therapies Inc Marriage & Family Therapist Past Accepting new patients
Neurotherapeutic Pediatric Therapies Inc Marriage & Family Therapist Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1305158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751414400000",
    "number": "1487946133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 HIGH ST",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970452241",
            "telephone_number": "503-372-5147",
            "fax_number": "503-266-8632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14839 SE 82ND DR",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970157624",
            "telephone_number": "503-372-5147",
            "fax_number": "503-650-4302"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2274 SW 2nd St Ste D",
            "address_purpose": "LOCATION",
            "city": "McMinnville",
            "state": "OR",
            "postal_code": "971285597",
            "country_code": "US",
            "telephone_number": "503-372-5147 x6",
            "fax_number": "503-266-8632",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5291 NE Elam Young Pkwy Ste 160",
            "address_purpose": "LOCATION",
            "city": "Hillsboro",
            "state": "OR",
            "postal_code": "971247560",
            "country_code": "US",
            "telephone_number": "503-372-5147 x6",
            "fax_number": "503-266-8632",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10130 NE Skidmore St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972203570",
            "country_code": "US",
            "telephone_number": "503-372-5147",
            "fax_number": "503-650-4302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LICHTENBERG",
        "first_name": "MICHAEL",
        "middle_name": "TODD",
        "name_prefix": "Mr.",
        "credential": "M.A., MCFT, QMHP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-12",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OR",
            "license": "T2049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clackamas, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2025; 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.