Active NPI
Maryanne Rose, LCSW
- Mental Health Counselor
- Portland, OR
National Provider Identifier
1497930697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- L2893
- Practice address
- 9900 SW Wilshire St
#130
Portland, OR 97225-5035 - Phone
- (503) 890-1180
- Fax
- (503) 473-8644
- NPI assigned
- Jan 7, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | L2893 | OR | Primary |
Addresses
Primary practice location
9900 SW Wilshire St
#130
Portland, OR 97225-5035
Mailing address
9900 SW Wilshire St
#130
Portland, OR 97225-5035
Phone (503) 890-1180
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L2893 | OR | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1199664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1199664000000",
"number": "1497930697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9900 SW WILSHIRE ST",
"address_2": "#130",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972255035",
"telephone_number": "503-890-1180",
"fax_number": "503-473-8644"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9900 SW WILSHIRE ST",
"address_2": "#130",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972255035",
"telephone_number": "503-890-1180",
"fax_number": "503-473-8644"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSE",
"first_name": "MARYANNE",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-01-07",
"last_updated": "2008-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": "L2893",
"primary": true
}
],
"identifiers": [],
"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 Jan 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.