NPIMap

Organization Active NPI

Holistic & Integrative Psychotherapy, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Portland, OR
National Provider Identifier
1639961378
Registry record updated Jul 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
HOLISTIC & INTEGRATIVE PSYCHOTHERAPY, LLC
Practice address
5525 E Burnside St
Portland, OR 97215-1258
Phone
(541) 936-9783
NPI assigned
May 19, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2025

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

Authorized official

Name
Samantha SudanoNPI 1316346398
Title
Owner
Phone
(503) 893-4830

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

5525 E Burnside St
Portland, OR 97215-1258

Mailing address

5525 E Burnside St
Portland, OR 97215-1258

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1747612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753401600000",
    "number": "1639961378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5525 E BURNSIDE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972151258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5525 E BURNSIDE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972151258",
            "telephone_number": "541-936-9783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLISTIC & INTEGRATIVE PSYCHOTHERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-19",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A",
        "authorized_official_last_name": "SUDANO",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-893-4830"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2025; 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.