Miranda Tai Campbell Acharya, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L8514 Issued in OR

Practice address

6906 N Richards St
Portland, OR 97203-6138

Phone

(971) 266-1081

Fax

(503) 575-3749

NPI assigned

Oct 10, 2014

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Embodied Life Therapy Center LLC

  • Clinical Social Worker
  • Portland, OR
  • NPI 1265039564
  NPD
• Cascadia Health

  • Multi-Specialty Clinic/Center
  • Portland, OR
  • NPI 1467591768
  NPD (past)

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

{
    "created_epoch": "1412899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1801290408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1622 NE COUCH ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972323052",
            "telephone_number": "503-753-6373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6906 N RICHARDS ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972036138",
            "telephone_number": "971-266-1081",
            "fax_number": "503-575-3749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACHARYA",
        "first_name": "MIRANDA",
        "middle_name": "TAI CAMPBELL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-10",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L8514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Josefina Wendy Acevedo-Giles
• Lowhren Kathleen Aceves
• Acg Group
• Dane Achalas
• Darshan Acharya, M.D.
• Emelia Ama Acheampong, LCSW
• Anupama Kurup Acheson, MD
• Laurie Achilles
• Lola Achilova, P.A.-C
• Christopher A Achterman, MD

• 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 Dec 11, 2020; 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.