Organization Active NPI

Understory Psychotherapy

  • Mental Health Counselor
  • Portland, OR
National Provider Identifier
1528801404
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
UNDERSTORY PSYCHOTHERAPY
Practice address
5707 NE 12TH Ave
Portland, OR 97211-4217
Phone
(614) 361-3027
NPI assigned
Jun 17, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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

Authorized official

Name
Avery Lewis, REGISTERED ASSOCIATENPI 1437862760
Title
Owner
Phone
(614) 361-3027

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

5707 NE 12TH Ave
Portland, OR 97211-4217

Mailing address

5707 NE 12TH Ave
Portland, OR 97211-4217
Phone (614) 361-3027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1718582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718582400000",
    "number": "1528801404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5707 NE 12TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972114217",
            "telephone_number": "614-361-3027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5707 NE 12TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972114217",
            "telephone_number": "614-361-3027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNDERSTORY PSYCHOTHERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-17",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "AVERY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "614-361-3027",
        "authorized_official_credential": "REGISTERED ASSOCIATE"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "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 Jun 17, 2024; 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.