Individual provider Active NPI

Eric Rose, MA

  • Mental Health Counselor
  • Portland, OR
National Provider Identifier
1922428564
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
905 SE 14TH Ave
Portland, OR 97214-2569
Phone
(503) 622-8964
Fax
(503) 715-5469
NPI assigned
Apr 22, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

905 SE 14TH Ave
Portland, OR 97214-2569

Mailing address

905 SE 14TH Ave
Portland, OR 97214-2569
Phone (503) 622-8964

Other names 1

  • Eric Norman Former name

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
I20240215003201 OR Practitioner - Mental Health Counselor 8921442153 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Larsen Sanchez Psychology LLCGroup PAC ID 6608138383, 17 clinicians

Practice addresses (Care Compare)

3050 SE Division St
Suite 215
Portland, OR 97202-1451

3050 SE Division St
Suite 215
Portland, OR 97202-1997
Phone (503) 622-8964

905 SE 14TH Ave
Portland, OR 97214-2569
Phone (503) 622-8964

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Lifeworks NW Mental Health PastSince Jun 19, 2017 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1398124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1922428564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 SE 14TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972142569",
            "telephone_number": "503-622-8964",
            "fax_number": "503-715-5469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 SE 14TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972142569",
            "telephone_number": "503-622-8964",
            "fax_number": "503-715-5469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "ERIC",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-22",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIC",
            "last_name": "NORMAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.