Julie A Keanaaina, LCSW, LICSW, MBA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L5390 Issued in OR

Practice address

222 NW Davis St Ste 309
Portland, OR 97209-3900

Phone

(503) 334-3035

Fax

(503) 961-9212

NPI assigned

Dec 16, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Julie A Misseldine Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Business Administration

State licenses

Practice roles

Locations

Interoperability endpoints

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

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.

• Psychological Services Connection LLC

  • Psychologist
  • Portland, OR
  • NPI 1275260465

  Social Worker

  Medicare reassignment NPD Authorized official
• Western Psychological and Counseling Services LLC

  dba LifeStance Health

  • Clinical Psychologist
  • Tacoma, WA
  • NPI 1912008178

  OR, Social Worker

  Medicare reassignment NPD
• Western Psychological and Counseling Services LLC

  dba LifeStance Health

  • Clinical Psychologist
  • Vancouver, WA
  • NPI 1629345731
  NPD

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

{
    "created_epoch": "1292457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661299200000",
    "number": "1780987511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 NW DAVIS ST STE 309",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972093900",
            "telephone_number": "503-334-3035",
            "fax_number": "503-961-9212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 NW DAVIS ST STE 309",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972093900",
            "telephone_number": "503-334-3035",
            "fax_number": "503-961-9212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 NW Bethany Blvd",
            "address_2": "Suite 320",
            "address_purpose": "LOCATION",
            "city": "Beaverton",
            "state": "OR",
            "postal_code": "970065208",
            "country_code": "US",
            "telephone_number": "503-659-5515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEANAAINA",
        "first_name": "JULIE",
        "middle_name": "A",
        "credential": "LCSW, LICSW, MBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-16",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L5390",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "HI",
            "license": "1774",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIE",
            "last_name": "MISSELDINE",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Monica Chan Kdep
• Bory Kea, M.D.
• Toby Ji Keagy
• Jaime E Kean, MD
• Patricia Marie Kean, LMT
• Kathleen Ann Keane, L.AC
• Kayla Fay Keane
• Teresa Catherine Keane, RN, MSN, PMHNP
• Keanu Chiropractic LLC
• Kearney Behavior Consulting LLC

• Clinical Social Worker in Portland, OR
• Providers in Portland, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.