Individual provider Active NPI

Cassie Liu

  • Mental Health Counselor
  • Portland, OR
National Provider Identifier
1629327044
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C5203 Issued in OR
Practice address
2929 SW Multnomah Blvd Ste 102
Portland, OR 97219-4070
Phone
(971) 704-5009
NPI assigned
Aug 30, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LH61567006 WA
Mental Health Counselor 101YM0800X C5203 OR Primary

Addresses

Primary practice location

2929 SW Multnomah Blvd Ste 102
Portland, OR 97219-4070

Mailing address

2929 SW Multnomah Blvd Ste 102
Portland, OR 97219-4070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Mar 21, 2024 through Mar 21, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
C5203ORMDMental Health Counselor
LH61567006WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Kristen Genzano Therapy LLC PastSince Sep 1, 2022 Accepting new patients
Virginia Garcia Memorial Health Center Past Accepting new patients

Organizations & group practices 2

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": "1346284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1629327044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2929 SW MULTNOMAH BLVD STE 102",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972194070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2929 SW MULTNOMAH BLVD STE 102",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972194070",
            "telephone_number": "971-704-5009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIU",
        "first_name": "CASSIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-30",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH61567006",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C5203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.