Janice Constantino, LPC, CADC 1

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C5387 Issued in OR

Practice address

1841 SW Merlo Dr
Beaverton, OR 97003-5013

Phone

(503) 941-3210

NPI assigned

Jan 5, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Janice Mallari Vicedo Former name

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lifestancehealth.janiceconstantino@148835.advancedmd-direct.com

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.

• Neighborhood Health Center

  • Federally Qualified Health Center (FQHC)
  • Portland, OR
  • NPI 1174820815
  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Northwest

  • General Practice Physician
  • Portland, OR
  • NPI 1184786527
  Medicare reassignment
• Kaiser Foundation Health Plan of the Northwest

  • Clinic/Center
  • Hillsboro, OR
  • NPI 1942718622
  NPD
• Neighborhood Health Center

  • Federally Qualified Health Center (FQHC)
  • Hillsboro, OR
  • NPI 1164793469
  NPD
• Neighborhood Health Center

  • Federally Qualified Health Center (FQHC)
  • Hillsboro, OR
  • NPI 1356725998
  NPD
• Neighborhood Health Center

  • Federally Qualified Health Center (FQHC)
  • Milwaukie, OR
  • NPI 1083984264
  NPD (past)
• Neighborhood Health Center

  • Federally Qualified Health Center (FQHC)
  • Oregon City, OR
  • NPI 1457902561
  NPD (past)

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

{
    "created_epoch": "1420416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632441600000",
    "number": "1669860383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7320 SW HUNZIKER RD STE 300",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972232302",
            "telephone_number": "503-941-3033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1841 SW MERLO DR",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970035013",
            "telephone_number": "503-941-3210"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10690 NE Cornell Rd Ste 220",
            "address_purpose": "LOCATION",
            "city": "Hillsboro",
            "state": "OR",
            "postal_code": "971249224",
            "country_code": "US",
            "telephone_number": "503-848-5861",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONSTANTINO",
        "first_name": "JANICE",
        "credential": "LPC, CADC 1",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-05",
        "last_updated": "2021-09-24",
        "certification_date": "2021-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C5387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500697420",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANICE",
            "last_name": "VICEDO",
            "middle_name": "MALLARI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Corey Connare
• Connected Counseling & Wellness, LLC
• Dan James Connelly
• Kylie Conrad
• Lauren Patricia Elizabeth Constantine
• Anthony Perry Conte
• Laureen Conti
• Maria Contreras Lopez
• Joey Conyers, LMT
• Megan Coogan Lynch

• Professional Counselor in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Professional Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.