Individual provider Active NPI

Rebecca Sue Lancaster, PHD

  • Clinical Psychologist
  • Clackamas, OR
National Provider Identifier
1548440878
Registry record updated Jun 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3582 Issued in OR
Practice address
9123 SE Saint Helens St Ste 270B
Clackamas, OR 97015-6801
Phone
(855) 583-2842
Fax
(503) 678-9751
NPI assigned
Nov 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 20042211A IN
Clinical Psychologist 103TC0700X 3582 OR Primary

Addresses

Primary practice location

9123 SE Saint Helens St Ste 270B
Clackamas, OR 97015-6801

Mailing address

9123 SE Saint Helens St Ste 270a
Clackamas, OR 97015-6801
Phone (317) 294-2452

Other identifiers 1

IdentifierTypeStateIssuer
200936550MedicaidIN

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address rebeccalancaster@licensedpsychologyassociates.com
Direct Messaging Address rebecca@lancasterpsychologyllc.cm

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150925002299 TX Practitioner - Clinical Psychologist 6709968019 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
20042211AINMDClinical Psychologist
3582ORMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Deer Oaks Geriatric Services P C Clinical CurrentSince Aug 3, 2015 Accepting new patients
Licensed Psychology Associates LLC PastSince Dec 6, 2022 Accepting new patients
Deer Oaks Mental Health Associates PC Clinical Past Accepting new patients

Locations

7272 Wurzbach Rd
Ste 706
San Antonio, TX 78240
Phone (210) 615-3401

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": "1194048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749081600000",
    "number": "1548440878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9123 SE SAINT HELENS ST STE 270A",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970156801",
            "telephone_number": "317-294-2452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9123 SE SAINT HELENS ST STE 270B",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970156801",
            "telephone_number": "855-583-2842",
            "fax_number": "503-678-9751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANCASTER",
        "first_name": "REBECCA",
        "middle_name": "SUE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-03",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20042211A",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "3582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200936550",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rebeccalancaster@licensedpsychologyassociates.com",
            "affiliation": "N",
            "address_1": "9123 SE Saint Helens St Ste 270B",
            "city": "Clackamas",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970156801",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rebecca@lancasterpsychologyllc.cm",
            "affiliation": "N",
            "address_1": "9123 SE Saint Helens St Ste 270B",
            "city": "Clackamas",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970156801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clackamas, OR

Sources for this page

Verify at the official NPI Registry.