Render Creative Space LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

RENDER CREATIVE SPACE LLC

Doing business as

Render: A Creative Space for Health & Wellness

Practice address

1250 NW Kearney
#1212
Portland, OR 97209-9720

Phone

(503) 210-1646

NPI assigned

Jun 16, 2020

Organization subpart

No

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

Authorized official

Name

Ms. Drew Smith, LPC, LCATNPI 1578030631

Title

Owner

Phone

(503) 210-1646

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Render: A Creative Space for Health & Wellness Doing business as

Electronic endpoints 2

Locations

Practitioners 1

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

• Drew Smith

  • Mental Health Counselor
  • Portland, OR
  • NPI 1578030631
  NPD Authorized official

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

{
    "created_epoch": "1592265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624579200000",
    "number": "1861017733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 NW KEARNEY",
            "address_2": "#1212",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 NW KEARNEY",
            "address_2": "#1212",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972099720",
            "telephone_number": "503-210-1646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENDER CREATIVE SPACE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-16",
        "last_updated": "2021-06-25",
        "certification_date": "2021-06-25",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DREW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-210-1646",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPC, LCAT"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1578030631",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@rendercreativespace.com",
            "affiliation": "N",
            "address_1": "1705 NW Kearney St",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972092321",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@rendercreativespace.com",
            "affiliation": "N",
            "address_1": "1250 NW Kearney",
            "address_2": "#1212",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972099720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Render: A Creative Space for Health & Wellness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Render: A Creative Space for Health & Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• 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 25, 2021; 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.