Individual provider Active NPI

Allen Walton Holmes, M.A., L.P.C.

  • Mental Health Counselor
  • Portland, OR
National Provider Identifier
1659419067
Registry record updated Apr 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C9658 Issued in OR
Practice address
11740 SW 68TH Pkwy Ste 200
Portland, OR 97223-9058
Phone
(703) 507-6866
NPI assigned
Feb 1, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X C9658 OR Primary

Addresses

Primary practice location

11740 SW 68TH Pkwy Ste 200
Portland, OR 97223-9058

Mailing address

8624 N Foss Ave
Portland, OR 97203-3619
Phone (703) 507-6866

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250418001435 OR Practitioner - Mental Health Counselor 8527583897 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mindful Therapy Group PCGroup PAC ID 4981872561, 654 clinicians

Practice addresses (Care Compare)

11740 SW 68TH Pkwy
Suite 200
Tigard, OR 97223-9058
Phone (971) 352-6984

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
C9658ORMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mindful Therapy Group PC Mental Health CurrentSince Apr 9, 2025 Accepting new patients

Locations

5440 SW Westgate Dr
Ste 350
Portland, OR 97221
Phone (503) 292-1100

11740 SW 68th Pkwy
Ste 200
Tigard, OR 97223
Phone (425) 477-4216

6505 216th St SW
Ste 100
Mountlake Terrace, WA 98043
Phone (425) 678-6463

Organizations & group practices 1

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": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744329600000",
    "number": "1659419067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8624 N FOSS AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972033619",
            "telephone_number": "703-507-6866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11740 SW 68TH PKWY STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972239058",
            "telephone_number": "703-507-6866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "ALLEN",
        "middle_name": "WALTON",
        "name_prefix": "Mr.",
        "credential": "M.A., L.P.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-01",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C9658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.