Individual provider Active NPI

Marla Catherine Connell

  • Mental Health Counselor
  • Oregon City, OR
National Provider Identifier
1942447669
Registry record updated Jul 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
998 Library CT
Oregon City, OR 97045-4041
Phone
(503) 655-8401
NPI assigned
Jan 16, 2009
Last updated
Jul 13, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2022

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 NU Primary

Addresses

Primary practice location

998 Library CT
Oregon City, OR 97045-4041

Mailing address

998 Library CT
Oregon City, OR 97045-4041
Phone (503) 655-8401

Other practice location 1

982 Mission St
San Francisco, CA 94103
Phone (415) 730-1346

Other identifiers 1

IdentifierTypeStateIssuer
1942447669MedicaidCA

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
I20241105003228 OR Practitioner - Clinical Social Worker 0345774980 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

150 Beavercreek Rd
Oregon City, OR 97045-4302

39740 Pleasant St
Sandy, OR 97055-6412
Phone (503) 655-8471

6605 SE Lake Rd
Milwaukie, OR 97222-2161
Phone (503) 655-8471

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
County of Clackamas Office of County Auditor CurrentSince Aug 30, 2024 Accepting new patients
Clackamas County CurrentSince Jul 17, 2022 Accepting new patients

Locations

2051 Kaen Rd
Ste 367
Oregon City, OR 97045
Phone (503) 742-5300

998 Courthouse Rd
Oregon City, OR 97045
Phone (503) 655-8470

39740 Pleasant St
Sandy, OR 97055
Phone (503) 563-7679

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1232064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1942447669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "998 LIBRARY CT",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970454041",
            "telephone_number": "503-655-8401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "998 LIBRARY CT",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970454041",
            "telephone_number": "503-655-8401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "982 Mission St",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "94103",
            "country_code": "US",
            "telephone_number": "415-730-1346",
            "fax_number": "415-597-8004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONNELL",
        "first_name": "MARLA",
        "middle_name": "CATHERINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-16",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1942447669",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oregon City, OR

Sources for this page

Verify at the official NPI Registry.