Portland Integrative Counseling Center

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

C2637 Issued in OR

Legal business name

PORTLAND INTEGRATIVE COUNSELING CENTER

Doing business as

Integrative Counseling in Portland

Practice address

811 E Burnside St Ste 217
Portland, OR 97214-1231

Phone

(971) 255-1565

NPI assigned

Sep 10, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Walt Emery, LPC

Title

Owner

Phone

(971) 255-1565

Specialties & licenses 1

Addresses

Other names 1

• Integrative Counseling in Portland Doing business as

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

{
    "created_epoch": "1378771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378771200000",
    "number": "1982039855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 82435",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972820435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 E BURNSIDE ST STE 217",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972141231",
            "telephone_number": "971-255-1565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTLAND INTEGRATIVE COUNSELING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-10",
        "last_updated": "2013-09-10",
        "status": "A",
        "authorized_official_last_name": "EMERY",
        "authorized_official_first_name": "WALT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "971-255-1565",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "OR",
            "license": "C2637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Integrative Counseling in Portland",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Portland Joint Reconstruction Clinic, P.C.
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• Community/Behavioral Health Agency in Portland, OR
• Providers in Portland, OR by specialty
• Community/Behavioral Health Agency in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2013; 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.