Individual provider Active NPI

Utpala Shanker, PH.D.

  • Mental Health Counselor
  • Hillsboro, OR
National Provider Identifier
1659691152
Registry record updated Jun 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
21210 NW Mauzey Rd
Hillsboro, OR 97124-9327
Phone
(503) 439-9531
Fax
(503) 531-3841
NPI assigned
Jun 7, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2010

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 Primary

Addresses

Primary practice location

21210 NW Mauzey Rd
Hillsboro, OR 97124-9327

Mailing address

PO Box 82819
Portland, OR 97282-0819
Phone (503) 233-5405

Other identifiers 2

IdentifierTypeStateIssuer
R0000WDBCHOtherMEDICARE GROUP
164936MedicaidOR

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
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Western Psychological and Counseling Services LLC Mental Health Past Accepting new patients
Western Psychological and Counseling Services PC 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": "1275868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275868800000",
    "number": "1659691152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 82819",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972820819",
            "telephone_number": "503-233-5405",
            "fax_number": "503-233-2694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21210 NW MAUZEY RD",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971249327",
            "telephone_number": "503-439-9531",
            "fax_number": "503-531-3841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANKER",
        "first_name": "UTPALA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-07",
        "last_updated": "2010-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "R0000WDBCH",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164936",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsboro, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2010; 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.