Active NPI
Mary Elizabeth Cameron, LPC, LMFT
- Marriage & Family Therapist
- Tigard, OR
National Provider Identifier
1639436207
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- T 0811
- Practice address
- 6745 SW Hampton St
Suite 200
Tigard, OR 97223-8394 - Phone
- (503) 484-3027
- Fax
- (503) 620-4673
- NPI assigned
- Apr 19, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | C 2775 | OR | |
| Marriage & Family Therapist | 106H00000X | T 0811 | OR | Primary |
Addresses
Primary practice location
6745 SW Hampton St
Suite 200
Tigard, OR 97223-8394
Mailing address
PO Box 219182
Portland, OR 97225-9182
Phone (503) 484-3027
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C 2775 | OR | MD | Professional Counselor |
| T 0811 | OR | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1334793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1334793600000",
"number": "1639436207",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 219182",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972259182",
"telephone_number": "503-484-3027",
"fax_number": "503-620-4673"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6745 SW HAMPTON ST",
"address_2": "SUITE 200",
"city": "TIGARD",
"state": "OR",
"postal_code": "972238394",
"telephone_number": "503-484-3027",
"fax_number": "503-620-4673"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMERON",
"first_name": "MARY",
"middle_name": "ELIZABETH",
"credential": "LPC, LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-04-19",
"last_updated": "2012-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OR",
"license": "C 2775",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "OR",
"license": "T 0811",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tigard, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.