Individual provider Active NPI

Melanie B Mamola, PROF.COUNSELOR ASS.

  • Professional Counselor
  • Beaverton, OR
National Provider Identifier
1891749941
Registry record updated Mar 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
C11222 Issued in OR
Practice address
9670 SW Beaverton Hillsdale Hwy
Beaverton, OR 97005-3307
Phone
(971) 229-4009
Fax
(866) 324-6009
NPI assigned
May 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X OR
Professional Counselor 101YP2500X C11222 OR Primary

Addresses

Primary practice location

9670 SW Beaverton Hillsdale Hwy
Beaverton, OR 97005-3307

Mailing address

9670 SW Beaverton Hillsdale Hwy
Beaverton, OR 97005-3307
Phone (971) 229-4009

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260223001853 OR Practitioner - Mental Health Counselor 0941557995 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brightspire Health LLCGroup PAC ID 2163866419, 27 clinicians

Practice addresses (Care Compare)

825 NE 20TH Ave
Suite 120
Portland, OR 97232-2268
Phone (971) 229-4009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C11222ORMDProfessional Counselor
3452ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Brightspire Health, LLC CurrentSince Feb 4, 2026 Accepting new patients

Locations

9670 SW Beaverton Hillsdale Hwy
Beaverton, OR 97005
Phone (503) 626-9494

825 NE 20th Ave
Ste 120
Portland, OR 97232
Phone (971) 229-4009

10824 SE Oak St
Portland, OR 97222
Phone (717) 516-1080

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772496000000",
    "number": "1891749941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9670 SW BEAVERTON HILLSDALE HWY",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970053307",
            "telephone_number": "971-229-4009",
            "fax_number": "866-324-6009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9670 SW BEAVERTON HILLSDALE HWY",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970053307",
            "telephone_number": "971-229-4009",
            "fax_number": "866-324-6009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMOLA",
        "first_name": "MELANIE",
        "middle_name": "B",
        "credential": "PROF.COUNSELOR ASS.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-22",
        "last_updated": "2026-03-03",
        "certification_date": "2026-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C11222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

Verify at the official NPI Registry.