Organization Active NPI

Lotus Teegarden, LLC

  • Clinical Social Worker
  • Portland, OR
National Provider Identifier
1679453104
Registry record updated Sep 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
LOTUS TEEGARDEN, LLC
Practice address
1940 NE Broadway St
Portland, OR 97232-1502
Phone
(971) 415-6344
Fax
(503) 388-3397
NPI assigned
Sep 4, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2025

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

Authorized official

Name
Lotus TeegardenNPI 1801270186
Title
Owner
Phone
(971) 415-6344

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

1940 NE Broadway St
Portland, OR 97232-1502

Mailing address

1940 NE Broadway St
Portland, OR 97232-1502
Phone (971) 415-6344

National Provider Directory

National Provider Directory

Locations

1940 NE Broadway St
Portland, OR 97232
Phone (503) 226-8918

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1756944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756944000000",
    "number": "1679453104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 NE BROADWAY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321502",
            "telephone_number": "971-415-6344",
            "fax_number": "503-388-3397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 NE BROADWAY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321502",
            "telephone_number": "971-415-6344",
            "fax_number": "503-388-3397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOTUS TEEGARDEN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-04",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A",
        "authorized_official_last_name": "TEEGARDEN",
        "authorized_official_first_name": "LOTUS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "971-415-6344"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "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 Sep 4, 2025; 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.