Active NPI
Emily Catherine Persico, MC
- Mental Health Counselor
- Portland, OR
National Provider Identifier
1821347535
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- C6219
- Practice address
- 11456 NE Knott St
Portland, OR 97220-1706 - Phone
- (503) 736-6671
- NPI assigned
- Sep 10, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | R3493 | OR | |
| Mental Health Counselor | 101YM0800X | C6219 | OR | Primary |
Addresses
Primary practice location
11456 NE Knott St
Portland, OR 97220-1706
Mailing address
15330 SE Yamhill St
Portland, OR 97233-2953
Phone (503) 200-7346
Other practice location 1
16100 NW Cornell Rd Ste 220
Beaverton, OR 97006-7334
Phone (503) 523-0296
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
| License | State | Type | Specialty |
|---|---|---|---|
| C6219 | OR | MD | Mental Health Counselor |
| R3493 | OR | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1347235200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651449600000",
"number": "1821347535",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15330 SE YAMHILL ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972332953",
"telephone_number": "503-200-7346"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11456 NE KNOTT ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972201706",
"telephone_number": "503-736-6671"
}
],
"practiceLocations": [
{
"address_1": "16100 NW Cornell Rd Ste 220",
"address_purpose": "LOCATION",
"city": "Beaverton",
"state": "OR",
"postal_code": "970067334",
"country_code": "US",
"telephone_number": "503-523-0296",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PERSICO",
"first_name": "EMILY",
"middle_name": "CATHERINE",
"credential": "MC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-09-10",
"last_updated": "2022-05-02",
"certification_date": "2022-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": "R3493",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": "C6219",
"primary": true
}
],
"identifiers": [],
"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 May 2, 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.