Life Guide N.W., LLC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Legal business name

LIFE GUIDE N.W., LLC

Practice address

13232 SE Stark St Ste 3
Portland, OR 97233-1573

Phone

(503) 255-2742

Fax

(503) 255-2742

NPI assigned

Apr 8, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Stevie Bradford Hoggans, MS, CACD III, QMHP

Title

Program Director

Phone

(503) 255-2742

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1270684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271030400000",
    "number": "1609192178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13232 SE STARK ST STE 3",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972331573",
            "telephone_number": "503-255-2742",
            "fax_number": "503-255-2742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13232 SE STARK ST STE 3",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972331573",
            "telephone_number": "503-255-2742",
            "fax_number": "503-255-2742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE GUIDE N.W., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-08",
        "last_updated": "2010-04-12",
        "status": "A",
        "authorized_official_last_name": "HOGGANS",
        "authorized_official_first_name": "STEVIE",
        "authorized_official_middle_name": "BRADFORD",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "503-255-2742",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MS, CACD III, QMHP"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Addiction (Substance Use Disorder) Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2010; 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.