MARY NICHOLS (NPI# 1053517110) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053517110 |
| Entity Type | Individual |
| Full Name | MARY NICHOLS |
| Practice Address |
1133 Nw 21st Ave Portland OR 97209-1513 |
| Practice Telephone | 5032225010 |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 0949 | OR | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144553074 | Mary A Nichols | Mechanotherapist | 195 - 1st Place N.w., Issaquah, WA 98027 | 2009-09-10 |
| 1407902299 | Mary E Nichols | Nurse Practitioner | 15005 Shady Grove Rd Ste 450, Rockville, MD 20850-6377 | 2007-01-26 |
| 1629032412 | Mary W Nichols | Nurse Practitioner | 76 Veterans Ave Bldg 30 Rm 202, Bath, NY 14810-0810 | 2006-04-17 |
| 1093348476 | Mary Etta Nichols | Case Manager/Care Coordinator | 2231 N Taylor Rd, Cleveland Heights, OH 44112-3044 | 2020-02-13 |
| 1881226355 | Mary L Nichols | Adult Companion | 1035 Portland Ave, Gladstone, OR 97027-2154 | 2020-02-12 |
| 1235789959 | Mary Alvin Nichols | Marriage & Family Therapist | 200 E Del Mar Blvd Ste 210, Pasadena, CA 91105-2551 | 2019-09-14 |
| 1679034813 | Mary Nichols | Behavior Technician | 2075 Lincoln Ave Ste D, San Jose, CA 95125-3513 | 2019-03-29 |
| 1770998189 | Mary Ann Nichols | Counselor | 190 Lime Quarry Rd, Ste #115, Madison, AL 35758-8962 | 2014-06-24 |
| 1437469152 | Mary Nichols | Nurse Practitioner | 1301 Sam Perry Blvd, Fredericksburg, VA 22401-8420 | 2010-10-15 |
| 1447564216 | Mary Lorene Nichols | Marriage & Family Therapist | 451 Lytton Ave, Palo Alto, CA 94301-1535 | 2010-08-03 |
| Street Address |
1133 NW 21ST AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97209-1513 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366424681 | Luahna Ude | Psychologist | 1133 Nw 21st Ave, Portland, OR 97209-1513 | 2005-11-14 |
| 1861974776 | Mary Lee Nichols Phd LLC | Psychologist | 1133 Nw 21st Ave, Portland, OR 97209-1513 | 2018-09-06 |
| 1679024327 | Marney Hoffman, Phd | Counselor | 1133 Nw 21st Ave, Suite 201, Portland, OR 97209-1513 | 2016-10-18 |
| 1063768893 | Robert Poe | Psychologist | 1133 Nw 21st Ave, Suite 204, Portland, OR 97209-1513 | 2012-07-30 |
| 1538332499 | Lisa P. Senders | Psychologist | 1133 Nw 21st Ave, Suite 203, Portland, OR 97209-1513 | 2008-04-10 |
| 1740468867 | Kathryn Senders | Counselor | 1133 Nw 21st Ave, Portland, OR 97209-1513 | 2008-01-31 |
| 1831314541 | Luahna Ude, Phd, PC | Psychologist | 1133 Nw 21st Ave, Portland, OR 97209-1513 | 2007-04-16 |
| 1801019641 | Anne K Robertson | Psychologist | 1133 Nw 21st Ave, Portland, OR 97209-1513 | 2007-04-10 |
| 1992844575 | Pete Morones | Psychologist | 1133 Nw 21st Ave, Portland, OR 97209-1513 | 2007-02-06 |
| 1992854665 | James Earl Reavis | Social Worker | 1133 Nw 21st Ave, Portland, OR 97209-1513 | 2007-01-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508476250 | Harrington Health Clinic | Nurse Practitioner | 310 Nw Glisan Street, Portland, OR 97209 | 2020-08-07 |
| 1619599636 | Rivers Way Training Clinic | Community/Behavioral Health | 2049 Nw Hoyt, Portland, OR 97209 | 2020-05-13 |
| 1518590538 | Julie Kay Igarta | Registered Nurse | 140 Northwest 14th Avenue, Portland, OR 97209 | 2020-02-18 |
| 1407492002 | Oregon Injection Clinic | Clinic/Center | 1500 Nw Lovejoy, 106, Portland, OR 97209 | 2019-11-19 |
| 1487202883 | Ann Tesora | Massage Therapist | 1320 Northwest 20th Avenue, Portland, OR 97209 | 2019-08-28 |
| 1972160455 | Vincent Martin | Massage Therapist | 210 Sw 17th Avenue, Portland, OR 97209 | 2019-05-21 |
| 1154896546 | Jennifer Marie Dodd | Social Worker | 1722 Nw Raleigh St Spc 412, Portland, OR 97209 | 2018-10-11 |
| 1922551910 | Ashley Crowell | Physician Assistant | 949 Nw Overton St Unit 306, Portland, OR 97209 | 2016-07-26 |
| 1326408394 | Jennifer Blain | Counselor | 324 Nw Davis, Portland, OR 97209 | 2016-03-03 |
| 1275993255 | Lauren Dodson | Licensed Practical Nurse | 324 Nw Davis St, Portland, OR 97209 | 2016-03-03 |
| Find all providers in zip 97209 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508466574 | Jessica Michelle Simonetti | Psychologist | Portland Psychotherapy Clinic, Research and Training Ce, 3700 N Williams Ave, Portland, OR 97227 | 2020-10-29 |
| 1811518434 | Nathaniel Israel | Psychologist | 7419 Se Woodstock Blvd, Portland, OR 97206-5838 | 2020-05-05 |
| 1477112480 | Stella Beatriz Kerl-mcclain | Psychologist | 2826 Sw Ridge Dr, Portland, OR 97219-6205 | 2019-06-12 |
| 1184281438 | Nicholas Alexander Schollars | Psychologist | 3050 Se Division St # 215, Portland, OR 97202-1451 | 2019-05-22 |
| 1639637432 | Bayside Psychology and Consulting, LLC | Psychologist | 1 Union St Ste 402, Portland, ME 04101-4048 | 2019-03-11 |
| 1942766985 | Alexandra R. Lash | Psychologist | 386 Fore St, Portland, ME 04101-4047 | 2019-02-14 |
| 1811416068 | Matthew Lundeberg | Psychologist | 10300 Sw Greenburg Rd Ste 271, Portland, OR 97223-5415 | 2017-09-19 |
| 1083130991 | Tawayne Nolen Malone Jr. | Psychologist | 0615 Sw Palatine Hill Road, Tawayne Malone - Msc 2159, Portland, OR 97219 | 2017-08-22 |
| 1093241838 | Dr Patricia Clark | Psychologist | 1132 Sw 19th Ave, Portland, OR 97205-1740 | 2017-05-11 |
| 1639527575 | Randall David Wright | Psychologist | 1827 Ne 44th Ave Ste 320, Portland, OR 97213-1443 | 2016-06-01 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.