Active NPI
Andrea Lucio Rosales, MA
- Mental Health Counselor
- Hillsboro, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- R6312
- Practice address
- 9620 NE Tanasbourne Dr Ste 300
Hillsboro, OR 97124-7844 - Phone
- (503) 207-5476
- NPI assigned
- Jun 22, 2015
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | R6312 | OR | Primary |
| Adult Companion | 372600000X |
Addresses
Primary practice location
9620 NE Tanasbourne Dr Ste 300
Hillsboro, OR 97124-7844
Mailing address
PO Box 8459
Portland, OR 97207-8459
Phone (503) 238-0769
Other practice location 1
847 NE 19th Ave
Suite 100
Portland, OR 97232-2684
Phone (503) 238-0769
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1915 NE Stucki Ave
Suite 400
Hillsboro, OR 97006-6938
Phone (844) 408-0014
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R6312 | OR | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifeline Medical Center | Mental Health | Current | Accepting new patients |
Locations
1915 NE Stucki Ave
Ste 400
Hillsboro, OR 97006
Phone (844) 408-0014
1925 NE Stucki Ave
Ste 150
Hillsboro, OR 97006
Interoperability endpoints
- https://api.platform.athenahealth.com/20067/brand/1/csg/1/fhir/r4
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1434931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669161600000",
"number": "1578945929",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8459",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972078459",
"telephone_number": "503-238-0769"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9620 NE TANASBOURNE DR STE 300",
"city": "HILLSBORO",
"state": "OR",
"postal_code": "971247844",
"telephone_number": "503-207-5476"
}
],
"practiceLocations": [
{
"address_1": "847 NE 19th Ave",
"address_2": "Suite 100",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972322684",
"country_code": "US",
"telephone_number": "503-238-0769",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LUCIO ROSALES",
"first_name": "ANDREA",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-22",
"last_updated": "2022-11-23",
"certification_date": "2022-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": "R6312",
"primary": true
},
{
"code": "372600000X",
"taxonomy_group": "",
"desc": "Adult Companion",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hillsboro, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.