Individual provider Active NPI

Angela Mae Duncan, M.ED., LPC

  • Mental Health Counselor
  • Lake Oswego, OR
National Provider Identifier
1720327000
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C8568 Issued in OR
Practice address
5285 Meadows Rd Ste 170
Lake Oswego, OR 97035-3478
Phone
(503) 726-5216
NPI assigned
Feb 6, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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 05991 OK
Mental Health Counselor 101YM0800X C8568 OR Primary

Addresses

Primary practice location

5285 Meadows Rd Ste 170
Lake Oswego, OR 97035-3478

Mailing address

35077 Goss LN
Poteau, OK 74953-7789
Phone (918) 649-7426

Other identifiers 2

IdentifierTypeStateIssuer
200481270AMedicaidOK
200481170BMedicaidOK

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
I20240905002161 OR Practitioner - Mental Health Counselor 5991245938 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
05991OKMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Sapphire Blue Behavioral Health Solutions Mental Health CurrentSince Oct 1, 2024 Accepting new patients

Locations

5285 Meadows Rd
Ste 170
Lake Oswego, OR 97035
Phone (503) 276-5216

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, 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": "1360108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1720327000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35077 GOSS LN",
            "city": "POTEAU",
            "state": "OK",
            "postal_code": "749537789",
            "telephone_number": "918-649-7426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5285 MEADOWS RD STE 170",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970353478",
            "telephone_number": "503-726-5216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNCAN",
        "first_name": "ANGELA",
        "middle_name": "MAE",
        "credential": "M.ED., LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-06",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OK",
            "license": "05991",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C8568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200481270A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200481170B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Oswego, OR

Sources for this page

Verify at the official NPI Registry.