NPIMap

Individual provider Active NPI

Italia M Hensley

  • Mental Health Counselor
  • Portland, OR
National Provider Identifier
1700408879
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
921 SE 50TH Ave
Portland, OR 97215-2601
Phone
(971) 221-8664
NPI assigned
May 12, 2020
Last updated
Jun 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary
Case Manager/Care Coordinator 171M00000X

Addresses

Primary practice location

921 SE 50TH Ave
Portland, OR 97215-2601

Mailing address

921 SE 50TH Ave
Portland, OR 97215-2601

Other practice location 1

13317 SE Powell Blvd
Portland, OR 97236-3335
Phone (503) 760-9606

Other practice location 2

18980 Leland Rd
Oregon City, OR 97045-8511
Phone (503) 650-8605

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

Practice roles

OrganizationSpecialtyStatusNew patients
Congruent Therapy LLC Mental Health Current Accepting new patients
Cascadia Health PastSince Sep 1, 2020 Accepting new patients
Cascadia Health PastSince May 1, 2020 Accepting new patients

Locations

1110 SE Alder St
Ste 301
Portland, OR 97214
Phone (503) 317-7780

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1589241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1700408879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 SE 50TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972152601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 SE 50TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972152601",
            "telephone_number": "971-221-8664"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13317 SE Powell Blvd",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972363335",
            "country_code": "US",
            "telephone_number": "503-760-9606",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18980 Leland Rd",
            "address_purpose": "LOCATION",
            "city": "Oregon City",
            "state": "OR",
            "postal_code": "970458511",
            "country_code": "US",
            "telephone_number": "503-650-8605",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENSLEY",
        "first_name": "ITALIA",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-12",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Jun 15, 2022; 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.