Individual provider Active NPI

Miriam Resnick, MSW

  • Mental Health Counselor
  • Portland, OR
National Provider Identifier
1508034521
Registry record updated Feb 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
232 Issued in OR
Practice address
833 SW 11TH Ave
Suite 925
Portland, OR 97205-2125
Phone
(503) 223-7620
Fax
(503) 223-3345
NPI assigned
Feb 12, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 232 OR Primary

Addresses

Primary practice location

833 SW 11TH Ave
Suite 925
Portland, OR 97205-2125

Mailing address

833 SW 11TH Ave
Suite 925
Portland, OR 97205-2125
Phone (503) 223-7620

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

LicenseStateTypeSpecialty
232ORMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1202774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202774400000",
    "number": "1508034521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 SW 11TH AVE",
            "address_2": "SUITE 925",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052125",
            "telephone_number": "503-223-7620",
            "fax_number": "503-223-3345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 SW 11TH AVE",
            "address_2": "SUITE 925",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052125",
            "telephone_number": "503-223-7620",
            "fax_number": "503-223-3345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RESNICK",
        "first_name": "MIRIAM",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-12",
        "last_updated": "2008-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "232",
            "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 Feb 12, 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.

Verify at the official NPI Registry.