Organization Active NPI

Black Therapist & Company, LLC

  • Clinical Social Worker
  • Beaverton, OR
National Provider Identifier
1942951405
Registry record updated Jan 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
BLACK THERAPIST & COMPANY, LLC
Practice address
10700 SW Beaverton Hillsidale Hwy
BLDG #3, Suite # 560
Beaverton, OR 97005
Phone
(503) 628-9452
Fax
(503) 356-3087
NPI assigned
Jan 15, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2022

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

Authorized official

Name
Rosemarie Hemmings, PH.D., LCSWNPI 1235431214
Title
Owner
Phone
(503) 628-9452

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

10700 SW Beaverton Hillsidale Hwy
BLDG #3, Suite # 560
Beaverton, OR 97005

Mailing address

6107 SW Murray Blvd # 310
Beaverton, OR 97008-4421
Phone (503) 628-9452

Other identifiers 1

IdentifierTypeStateIssuer
1235431214OtherINDIVIDUAL NPI#

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1642204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642204800000",
    "number": "1942951405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6107 SW MURRAY BLVD # 310",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970084421",
            "telephone_number": "503-628-9452",
            "fax_number": "503-356-3087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10700 SW BEAVERTON HILLSIDALE HWY",
            "address_2": "BLDG #3, SUITE # 560",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "97005",
            "telephone_number": "503-628-9452",
            "fax_number": "503-356-3087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACK THERAPIST & COMPANY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-15",
        "last_updated": "2022-01-15",
        "certification_date": "2022-01-15",
        "status": "A",
        "authorized_official_last_name": "HEMMINGS",
        "authorized_official_first_name": "ROSEMARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-628-9452",
        "authorized_official_credential": "PH.D., LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI#",
            "identifier": "1235431214",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2022; 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.