Individual provider Active NPI

Alissa Lynn Bagan, LMHC

  • Mental Health Counselor
  • Portland, OR
National Provider Identifier
1730374646
Registry record updated Apr 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH60303393 Issued in WA
Practice address
4246 SE Belmont St
Portland, OR 97215-1676
Phone
(503) 445-8114
NPI assigned
Sep 13, 2007
Last updated
Apr 7, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LH60303393 WA Primary
Marriage & Family Therapist 106H00000X R1909 OR
Community/Behavioral Health Agency 251S00000X NU

Addresses

Primary practice location

4246 SE Belmont St
Portland, OR 97215-1676

Mailing address

4246 SE Belmont St
Portland, OR 97215-1676

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20260430002858 WA Practitioner - Mental Health Counselor 9133696768 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7507 NE 51St St
Vancouver, WA 98662-6007
Phone (360) 906-1190

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LH60303393WAMDMental Health Counselor
R1909ORMDMarriage & Family Therapist

Interoperability endpoints

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

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": "1189641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775520000000",
    "number": "1730374646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4246 SE BELMONT ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972151676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4246 SE BELMONT ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972151676",
            "telephone_number": "503-445-8114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGAN",
        "first_name": "ALISSA",
        "middle_name": "LYNN",
        "name_prefix": "Miss",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-13",
        "last_updated": "2026-04-07",
        "certification_date": "2026-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60303393",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OR",
            "license": "R1909",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.