Individual provider Active NPI

Ryan Scott Loiselle, LPC

  • Mental Health Counselor
  • Portland, OR
National Provider Identifier
1720434566
Registry record updated Apr 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C5073 Issued in OR
Practice address
3620 SE Powell Blvd Ste 102
Portland, OR 97202-1880
Phone
(503) 673-6190
NPI assigned
May 11, 2016
Last updated
Apr 14, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 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 R4492 OR
Mental Health Counselor 101YM0800X C5073 OR Primary

Addresses

Primary practice location

3620 SE Powell Blvd Ste 102
Portland, OR 97202-1880

Mailing address

7949 SE Glencoe Rd # 13
Milwaukie, OR 97222-1035
Phone (415) 305-9998

Other identifiers 1

IdentifierTypeStateIssuer
462796848MedicaidOR

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
I20240530001424 OR Practitioner - Mental Health Counselor 1456704535 Practice locations: Portland, OR

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3620 SE Powell Blvd
Suite 102
Portland, OR 97202-1880
Phone (503) 673-6190

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C5073ORMDMental Health Counselor
R4492ORMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
In Context, LLC Mental Health CurrentSince Jun 4, 2023 Accepting new patients
Larsen Sanchez Psychology, LLC Single Specialty PastSince Mar 14, 2025 Accepting new patients

Locations

3620 SE Powell Blvd
Ste 102
Portland, OR 97202
Phone (503) 486-8936

Organizations & group practices 2

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": "1462924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713052800000",
    "number": "1720434566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7949 SE GLENCOE RD # 13",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972221035",
            "telephone_number": "415-305-9998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3620 SE POWELL BLVD STE 102",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972021880",
            "telephone_number": "503-673-6190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOISELLE",
        "first_name": "RYAN",
        "middle_name": "SCOTT",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-11",
        "last_updated": "2024-04-14",
        "certification_date": "2024-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "R4492",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C5073",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "462796848",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.