Lightshinepdx LLC

Primary specialty

CounselorTaxonomy code 101Y00000X

Legal business name

LIGHTSHINEPDX LLC

Practice address

4531 SE Belmont St Ste 121
Portland, OR 97215-1675

Phone

(503) 358-2891

NPI assigned

Jan 3, 2024

Organization subpart

No

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

Authorized official

Name

Matthew Sprague Kidder, LPCNPI 1003302621

Title

Owner

Phone

(503) 358-2891

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.

• Matthew Sprague Kidder

  • Counselor
  • Portland, OR
  • NPI 1003302621
  NPD Authorized official

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

{
    "created_epoch": "1704240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706227200000",
    "number": "1952171753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4531 SE BELMONT ST STE 121",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972151675",
            "telephone_number": "503-358-2891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4531 SE BELMONT ST STE 121",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972151675",
            "telephone_number": "503-358-2891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTSHINEPDX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-03",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-26",
        "status": "A",
        "authorized_official_last_name": "KIDDER",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "SPRAGUE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-358-2891",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael L Lightfoot
• Katie Lighthart, AU.D.
• Emily Lighthipe, DPT
• Lighthouse Counseling Center LLC
• Vicky Lightning, LMT NCTMB
• Robert Stark Ligon III, D.C.
• Sharon Lii
• Alicia Like
• Nita Jennie Likes
• Ernest Likins, MA

• Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2024; 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.