Laura Marie Separa Therapy Services

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

C4399 Issued in OR

Legal business name

LAURA MARIE SEPARA THERAPY SERVICES

Practice address

610 SW Alder St
Suite 1100
Portland, OR 97205-3625

Phone

(503) 724-0943

NPI assigned

Feb 14, 2017

Organization subpart

No

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

Authorized official

Name

Laura Marie Separa

Title

Ma, LPC

Phone

(503) 724-0943

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1487030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487721600000",
    "number": "1770022493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 NE IRONCREEK TER",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971245150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 SW ALDER ST",
            "address_2": "SUITE 1100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972053625",
            "telephone_number": "503-724-0943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAURA MARIE SEPARA THERAPY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-14",
        "last_updated": "2017-02-22",
        "status": "A",
        "authorized_official_last_name": "SEPARA",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "MA, LPC",
        "authorized_official_telephone_number": "503-724-0943"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "OR",
            "license": "C4399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Portland, OR
• Providers in Portland, OR by specialty
• Community/Behavioral Health Agency in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2017; 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.