Embark Counseling NW, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

EMBARK COUNSELING NW, LLC

Practice address

15220 NW Laidlaw Rd Ste 240
Portland, OR 97229-7718

Phone

(503) 422-7215

Fax

(971) 339-8491

NPI assigned

Aug 3, 2021

Organization subpart

No

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

Authorized official

Name

Grace Jade Hamilton, LPCNPI 1043331143

Title

Owner

Phone

(503) 422-7215

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Grace Jade Hamilton, LPC

  • Mental Health Counselor
  • Portland, OR
  • NPI 1043331143
  NPD Authorized official

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

{
    "created_epoch": "1627948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627948800000",
    "number": "1922772011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17558",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972170558",
            "telephone_number": "503-422-7215",
            "fax_number": "971-339-8491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15220 NW LAIDLAW RD STE 240",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972297718",
            "telephone_number": "503-422-7215",
            "fax_number": "971-339-8491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMBARK COUNSELING NW, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-03",
        "last_updated": "2021-08-03",
        "certification_date": "2021-08-03",
        "status": "A",
        "authorized_official_last_name": "HAMILTON",
        "authorized_official_first_name": "GRACE",
        "authorized_official_middle_name": "JADE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-422-7215",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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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 Aug 3, 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.