Individual provider Active NPI

Emily Catherine Teegarden

  • Mental Health Counselor
  • Portland, OR
National Provider Identifier
1659852218
Registry record updated Apr 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
E.1800867-SUPV Issued in OH
Practice address
5100 S Macadam Ave Ste 350
Portland, OR 97239-3877
Phone
(971) 339-3537
NPI assigned
Aug 22, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X C.1500897 OH
Mental Health Counselor 101YM0800X E.1800867-SUPV OH Primary

Addresses

Primary practice location

5100 S Macadam Ave Ste 350
Portland, OR 97239-3877

Mailing address

5100 S Macadam Ave Ste 350
Portland, OR 97239-3877
Phone (971) 339-3537

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
I20241126000539 OR Practitioner - Mental Health Counselor 0941735070 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Portland DBT Institute IncGroup PAC ID 7911141742, 28 clinicians

Practice addresses (Care Compare)

5100 S Macadam Ave
Suite 350
Portland, OR 97239-3877
Phone (503) 231-7854

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E.1800867-SUPVOHMDMental Health Counselor
C.1500897OHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Portland DBT Institute, Inc. CurrentSince Nov 12, 2024 Accepting new patients

Locations

5200 S Macadam Ave
Ste 580
Portland, OR 97239
Phone (503) 231-7854

5100 S Macadam Ave
Ste 350
Portland, OR 97239
Phone (503) 231-7854

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": "1534896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1659852218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 S MACADAM AVE STE 350",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393877",
            "telephone_number": "971-339-3537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 S MACADAM AVE STE 350",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393877",
            "telephone_number": "971-339-3537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEEGARDEN",
        "first_name": "EMILY",
        "middle_name": "CATHERINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-22",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "C.1500897",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.1800867-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.