Active NPI
Philip Leo Yassenoff, LPCC
- Mental Health Counselor
- Portland, OR
National Provider Identifier
1659590347
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 2338
- Practice address
- 2415 SE 43Rd Ave Ste 200
Portland, OR 97206-1671 - Phone
- (503) 872-0151
- Fax
- (503) 239-5953
- NPI assigned
- Apr 24, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | E0002338 | OH | |
| Mental Health Counselor | 101YM0800X | 2338 | OH | Primary |
Addresses
Primary practice location
2415 SE 43Rd Ave Ste 200
Portland, OR 97206-1671
Mailing address
2415 SE 43Rd Ave Ste 200
Portland, OR 97206-1671
Phone (503) 872-0151
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 |
|---|---|---|---|
| E0002338 | OH | MD | Counselor |
| 2338 | OH | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1332806400000",
"number": "1659590347",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2415 SE 43RD AVE STE 200",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972061671",
"telephone_number": "503-872-0151",
"fax_number": "503-239-5953"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2415 SE 43RD AVE STE 200",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972061671",
"telephone_number": "503-872-0151",
"fax_number": "503-239-5953"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YASSENOFF",
"first_name": "PHILIP",
"middle_name": "LEO",
"credential": "LPCC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-24",
"last_updated": "2012-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "OH",
"license": "E0002338",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OH",
"license": "2338",
"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 Mar 27, 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.