Active NPI
Amy Swallow, LPC, LCAT, ATR-BC
- Mental Health Counselor
- Portland, OR
National Provider Identifier
1518376581
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- C4192
- Practice address
- 5280 SE Foster Rd
Portland, OR 97206-2936 - Phone
- (503) 312-6005
- NPI assigned
- Aug 4, 2014
- Last updated
- Feb 9, 2024
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | C4192 | OR | |
| Mental Health Counselor | 101YM0800X | C4192 | OR | Primary |
| Professional Counselor | 101YP2500X | C4192 | OR | |
| Art Therapist | 221700000X | ART-C-10205600 | OR |
Addresses
Primary practice location
5280 SE Foster Rd
Portland, OR 97206-2936
Mailing address
4207 SE Woodstock Blvd # 361
Portland, OR 97206-6267
Phone (503) 312-6005
Other practice location 1
4207 SE Woodstock Blvd # 361
Portland, OR 97206-6267
Phone (503) 312-6005
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 8, 2024 through Mar 8, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C4192 | OR | MD | Mental Health Counselor |
| ART-C-10205600 | OR | MD | Art Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707436800000",
"number": "1518376581",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4207 SE WOODSTOCK BLVD # 361",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972066267",
"telephone_number": "503-312-6005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5280 SE FOSTER RD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972062936",
"telephone_number": "503-312-6005"
}
],
"practiceLocations": [
{
"address_1": "4207 SE Woodstock Blvd # 361",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972066267",
"country_code": "US",
"telephone_number": "503-312-6005",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SWALLOW",
"first_name": "AMY",
"credential": "LPC, LCAT, ATR-BC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-08-04",
"last_updated": "2024-02-09",
"certification_date": "2024-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "OR",
"license": "C4192",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": "C4192",
"primary": true
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OR",
"license": "C4192",
"primary": false
},
{
"code": "221700000X",
"taxonomy_group": "",
"desc": "Art Therapist",
"state": "OR",
"license": "ART-C-10205600",
"primary": false
}
],
"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 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.