Mental Health & Addiction Therapy, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C2855 Issued in OR

Legal business name

MENTAL HEALTH & ADDICTION THERAPY, LLC

Practice address

511 SW 10TH Ave Ste 601
Portland, OR 97205-2707

Phone

(503) 597-8250

NPI assigned

Mar 9, 2017

Organization subpart

No

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

Authorized official

Name

Mrs. Niaz Larsen, LPC, CADC

Title

Mental Health & Addiction Therapist

Phone

(503) 804-1467

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1489017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489795200000",
    "number": "1619418647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4654 N VANCOUVER AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972172946",
            "telephone_number": "503-804-1467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 SW 10TH AVE STE 601",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052707",
            "telephone_number": "503-597-8250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTAL HEALTH & ADDICTION THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-09",
        "last_updated": "2017-03-18",
        "status": "A",
        "authorized_official_last_name": "LARSEN",
        "authorized_official_first_name": "NIAZ",
        "authorized_official_title_or_position": "MENTAL HEALTH & ADDICTION THERAPIST",
        "authorized_official_telephone_number": "503-804-1467",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC, CADC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "11-03-20",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C2855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2017; 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.