Susana Gomora

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

23-QMHP-R-2008 Issued in OR

Practice address

209 SW 4TH Ave Ste 520
Portland, OR 97204-1825

Phone

(971) 710-4424

Fax

(503) 988-4386

NPI assigned

Nov 23, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1195776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1770764334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 SW 4TH AVE STE 520",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972041825",
            "telephone_number": "503-988-5464",
            "fax_number": "503-988-4015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 SW 4TH AVE STE 520",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972041825",
            "telephone_number": "971-710-4424",
            "fax_number": "503-988-4386"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9650 Zelzah Ave",
            "address_purpose": "LOCATION",
            "city": "Northridge",
            "state": "CA",
            "postal_code": "913252003",
            "country_code": "US",
            "telephone_number": "818-993-9311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOMORA",
        "first_name": "SUSANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-23",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW60939",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "23-QMHP-R-2008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miguel Gomez I
• Silvia Gomez
• Tehniyah N Gomez, PNP-PC
• Teresa Gomez
• Zaida Natali Gomez, LMFT
• Christina Goncalves
• Jessica L Goncalves
• Laura Lee Gonce, LCSW
• Sierra Goncharoff, ND
• Lauren Gonia, RN

• Mental Health Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2023; 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.