Individual provider Active NPI

Amanda Bernal, LMFT

  • Marriage & Family Therapist
  • Lake Oswego, OR
National Provider Identifier
1962800789
Registry record updated Dec 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
T1575 Issued in OR
Practice address
5 Centerpointe Dr Ste 320
Lake Oswego, OR 97035-8696
Phone
(971) 400-7787
Fax
(971) 209-7260
NPI assigned
Dec 10, 2014
Last updated
Dec 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X T1575 OR Primary

Addresses

Primary practice location

5 Centerpointe Dr Ste 320
Lake Oswego, OR 97035-8696

Mailing address

5 Centerpointe Dr Ste 320
Lake Oswego, OR 97035-8696
Phone (971) 400-7787

Other names 1

  • Miss Amanda Mae McNulty 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
I20250109001141 OR Practitioner - Marriage and Family Therapist 4385172022 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

5 Centerpointe Dr
Suite 320
Lake Oswego, OR 97035-8696
Phone (971) 213-2837

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
T1575ORMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Western Psychological and Counseling Services LLC Mental Health CurrentSince Dec 7, 2024 Accepting new patients
Western Psychological and Counseling Services LLC Mental Health CurrentSince Dec 7, 2024 Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

44 Club Rd
Ste 200
Eugene, OR 97401
Phone (254) 393-5983

880 82nd Dr
Gladstone, OR 97027
Phone (503) 626-9494

2222 E Powell Blvd
Gresham, OR 97080
Phone (503) 669-4300

5 Centerpointe Dr
Ste 320
Lake Oswego, OR 97035
Phone (971) 213-2837

2525 NW Lovejoy St
Ste 204
Portland, OR 97210
Phone (503) 563-3420

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.amandabernal@148835.advancedmd-direct.com

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": "1418169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703548800000",
    "number": "1962800789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 CENTERPOINTE DR STE 320",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970358696",
            "telephone_number": "971-400-7787",
            "fax_number": "971-209-7260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 CENTERPOINTE DR STE 320",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970358696",
            "telephone_number": "971-400-7787",
            "fax_number": "971-209-7260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNAL",
        "first_name": "AMANDA",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-10",
        "last_updated": "2023-12-26",
        "certification_date": "2023-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OR",
            "license": "T1575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "MCNULTY",
            "middle_name": "MAE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lake Oswego, OR

Sources for this page

Verify at the official NPI Registry.