Active NPI
Vanessa Martinez
- Mental Health Counselor
- Tigard, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- C9563
- Practice address
- 11740 SW 68TH Pkwy Ste 200
Tigard, OR 97223-9058 - Phone
- (425) 477-4216
- NPI assigned
- Nov 15, 2009
- 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 | 180015368 | IL | |
| Mental Health Counselor | 101YM0800X | C9563 | OR | Primary |
Addresses
Primary practice location
11740 SW 68TH Pkwy Ste 200
Tigard, OR 97223-9058
Mailing address
5441 S Macadam Ave Ste R
Portland, OR 97239-6106
Phone (847) 337-0492
Other practice location 1
2122 Claremont Ln
Lake IN The Hills, IL 60156-6405
Phone (847) 337-0492
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
11740 SW 68TH Pkwy
Suite 200
Tigard, OR 97223-9058
Phone (971) 352-6984
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C9563 | OR | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifeline Medical Center | Mental Health | Current | Accepting new patients |
| Mindful Therapy Group PC | Mental Health | Current | Accepting new patients |
Locations
1415 W 22nd St
Oak Brook, IL 60523
Phone (312) 806-3800
5440 SW Westgate Dr
Ste 350
Portland, OR 97221
Phone (503) 292-1100
11740 SW 68th Pkwy
Ste 200
Tigard, OR 97223
Phone (425) 477-4216
6505 216th St SW
Ste 100
Mountlake Terrace, WA 98043
Phone (425) 678-6463
Interoperability endpoints
- https://api.platform.athenahealth.com/20067/brand/1/csg/1/fhir/r4
Organizations & group practices 2
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.
-
dba Mindful Therapy Group
- Clinical Social Worker
- Mountlake Terrace, WA
- NPI 1316238678
Mental Health, OR
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1258243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744329600000",
"number": "1922335793",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5441 S MACADAM AVE STE R",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972396106",
"telephone_number": "847-337-0492"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11740 SW 68TH PKWY STE 200",
"city": "TIGARD",
"state": "OR",
"postal_code": "972239058",
"telephone_number": "425-477-4216"
}
],
"practiceLocations": [
{
"address_1": "2122 Claremont Ln",
"address_purpose": "LOCATION",
"city": "Lake IN The Hills",
"state": "IL",
"postal_code": "601566405",
"country_code": "US",
"telephone_number": "847-337-0492",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MARTINEZ",
"first_name": "VANESSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-11-15",
"last_updated": "2025-04-11",
"certification_date": "2025-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IL",
"license": "180015368",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": "C9563",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tigard, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.