Porchlight Custom Counseling LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

PORCHLIGHT CUSTOM COUNSELING LLC

Practice address

455 S Knott St
Canby, OR 97013-4426

Phone

(503) 395-3301

NPI assigned

Oct 18, 2018

Organization subpart

No

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

Authorized official

Name

Mica Richards, LMHCNPI 1457617912

Title

Part Owner

Phone

(503) 395-3301

Specialties & licenses 3

Addresses

Practitioners 1

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

• Mica Richards, LMHC

  • Mental Health Counselor
  • Canby, OR
  • NPI 1457617912

  Addiction (Substance Use Disorder)

  NPD (past) Authorized official

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

{
    "created_epoch": "1539820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539820800000",
    "number": "1871069674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 344",
            "city": "TURNER",
            "state": "OR",
            "postal_code": "973920344",
            "telephone_number": "503-395-3301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 S KNOTT ST",
            "city": "CANBY",
            "state": "OR",
            "postal_code": "970134426",
            "telephone_number": "503-395-3301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORCHLIGHT CUSTOM COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-18",
        "last_updated": "2018-10-18",
        "status": "A",
        "authorized_official_last_name": "RICHARDS",
        "authorized_official_first_name": "MICA",
        "authorized_official_title_or_position": "PART OWNER",
        "authorized_official_telephone_number": "503-395-3301",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Canby, OR
• Providers in Canby, 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 Oct 18, 2018; 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.