NPIMap

Organization Active NPI

Youth Villages

  • Adolescent and Children Mental Health Clinic/Center
  • Lake Oswego, OR
National Provider Identifier
1992243992
Registry record updated Feb 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
License
M6979 Issued in OR
Legal business name
YOUTH VILLAGES
Practice address
2507 Christie Dr
Lake Oswego, OR 97034
Phone
(503) 635-3416
NPI assigned
Feb 9, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2017

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

Authorized official

Name
Daina Michelle Tague, LMSW, QHMP
Title
ER Diversion Specialist
Phone
(541) 513-4998

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X M6979 OR Primary

Addresses

Primary practice location

2507 Christie Dr
Lake Oswego, OR 97034

Mailing address

12945 SW Hawks Beard St
Tigard, OR 97223-1956

National Provider Directory

National Provider Directory
Tax ID family
Youth Villages19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

Practitioners & affiliated clinicians

Practitioners 98

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

View all 98

NPI Registry JSON

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

{
    "created_epoch": "1486598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486598400000",
    "number": "1992243992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12945 SW HAWKS BEARD ST",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972231956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2507 CHRISTIE DR",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "97034",
            "telephone_number": "503-635-3416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUTH VILLAGES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-09",
        "last_updated": "2017-02-09",
        "status": "A",
        "authorized_official_last_name": "TAGUE",
        "authorized_official_first_name": "DAINA",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "ER DIVERSION SPECIALIST",
        "authorized_official_telephone_number": "541-513-4998",
        "authorized_official_credential": "LMSW, QHMP"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "OR",
            "license": "M6979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Oswego, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2017; 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.