Active NPI
Cheryl Lane, PSYD
- Mental Health Counselor
- Beaverton, OR
National Provider Identifier
1548971310
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- R8063
- Practice address
- 11450 SW Cardinal Ter
Beaverton, OR 97008-5959 - Phone
- (503) 312-2873
- NPI assigned
- Dec 12, 2022
- Last updated
- Dec 12, 2022
- Sex
- Female
- Sole proprietor
- No
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 | R8063 | OR | Primary |
Addresses
Primary practice location
11450 SW Cardinal Ter
Beaverton, OR 97008-5959
Mailing address
11450 SW Cardinal Ter
Beaverton, OR 97008-5959
Phone (503) 312-2873
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 7, 2025 through Mar 7, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R8063 | OR | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1670803200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670803200000",
"number": "1548971310",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11450 SW CARDINAL TER",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970085959",
"telephone_number": "503-312-2873"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11450 SW CARDINAL TER",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970085959",
"telephone_number": "503-312-2873"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANE",
"first_name": "CHERYL",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-12-12",
"last_updated": "2022-12-12",
"certification_date": "2022-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": "R8063",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaverton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2022; 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.