Organization Active NPI

Halo Springs Wellness Center LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Portland, OR
National Provider Identifier
1851137665
Registry record updated Jul 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
HALO SPRINGS WELLNESS CENTER LLC
Practice address
310 SW 4TH Ave Ste 300
Portland, OR 97204-2320
Phone
(678) 849-5774
NPI assigned
Jul 2, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2026

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

Authorized official

Name
Ijeoma Jennifer OkehNPI 1578933230
Title
Pmhnp
Phone
(678) 849-5774

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

310 SW 4TH Ave Ste 300
Portland, OR 97204-2320

Mailing address

6433 Queens Court Trce
Mableton, GA 30126-7226
Phone (678) 849-5774

Other practice location 1

215 Marvin Miller Dr SW Ste 123
Atlanta, GA 30336-1813
Phone (404) 905-8963

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241122001005 GA Part B Supplier - Clinic/Group Practice 1052846409 Receives reassigned benefits from 1 practitioner
Practice locations: Atlanta, GA

National Provider Directory

National Provider Directory

Locations

215 Marvin Miller Dr SW
Ste 123
Atlanta, GA 30336
Phone (404) 905-8963

310 SW 4th Ave
Ste 300
Portland, OR 97204
Phone (503) 567-8605

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1719878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783382400000",
    "number": "1851137665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6433 QUEENS COURT TRCE",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301267226",
            "telephone_number": "678-849-5774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 SW 4TH AVE STE 300",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972042320",
            "telephone_number": "678-849-5774"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "215 Marvin Miller Dr SW Ste 123",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303361813",
            "country_code": "US",
            "telephone_number": "404-905-8963",
            "fax_number": "404-905-9327",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HALO SPRINGS WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-02",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A",
        "authorized_official_last_name": "OKEH",
        "authorized_official_first_name": "IJEOMA",
        "authorized_official_middle_name": "JENNIFER",
        "authorized_official_title_or_position": "PMHNP",
        "authorized_official_telephone_number": "678-849-5774"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "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 Jul 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.