NPIMap

Individual provider Active NPI

Brittany R Wienholz, LCSW

  • Mental Health Counselor
  • Portland, OR
National Provider Identifier
1760897102
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
7327 Issued in OR
Practice address
3939 NE Hancock St.
Suite 211
Portland, OR 97212
Phone
(971) 940-6729
Fax
(503) 200-1105
NPI assigned
Jun 24, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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
Clinical Social Worker 1041C0700X
Mental Health Counselor 101YM0800X 7327 OR Primary

Addresses

Primary practice location

3939 NE Hancock St.
Suite 211
Portland, OR 97212

Mailing address

3939 NE Hancock St.
Suite 211
Portland, OR 97212
Phone (971) 940-6729

Other practice location 1

11010 SE Division St Ste 202
Portland, OR 97266-6400
Phone (503) 335-5975

Other identifiers 1

IdentifierTypeStateIssuer
500679023MedicaidOR

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

State licenses

LicenseStateTypeSpecialty
7327ORMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Options Counseling Services of Oregon Mental Health PastSince Mar 25, 2016 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1403568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1760897102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3939 NE HANCOCK ST.",
            "address_2": "SUITE 211",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97212",
            "telephone_number": "971-940-6729",
            "fax_number": "503-200-1105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3939 NE HANCOCK ST.",
            "address_2": "SUITE 211",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97212",
            "telephone_number": "971-940-6729",
            "fax_number": "503-200-1105"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11010 SE Division St Ste 202",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972666400",
            "country_code": "US",
            "telephone_number": "503-335-5975",
            "fax_number": "503-335-5974",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIENHOLZ",
        "first_name": "BRITTANY",
        "middle_name": "R",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-24",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "7327",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500679023",
            "state": "OR"
        }
    ],
    "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 Jul 21, 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.