REBEL HEART THERAPY LLC (NPI# 1073146197) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073146197 |
| Entity Type | Organization |
| Organization Name | REBEL HEART THERAPY LLC |
| Practice Address |
1020 Sw Taylor St Ste 700 Portland OR 97205-2512 |
| Practice Telephone | 9713501122 |
| Mailing Telephone | 9713501122 |
| Enumeration Date | 2020-02-17 |
| Last Update Date | 2020-02-17 |
| Authorized Official Name | MS. MORGAN FITZ GIBBON (FOUNDER) |
| Authorized Official Telephone | 9713501122 |
| Authorized Official Credential | LMFT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | Behavioral Health & Social Service Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | REBEL HEART THERAPY LLC | 1020 Sw Taylor St Ste 700, Portland, OR 97205 |
| Street Address |
1020 SW TAYLOR ST STE 700 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97205-2512 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972841054 | Kim E. Lucey | Social Worker | 1020 Sw Taylor St Ste 700, 1125, Portland, OR 97205-2512 | 2013-01-23 |
| 1306459078 | Tehya Rice | Student in an Organized Health Care Education/Training Program | 1020 Sw Taylor St Ste 700, Portland, OR 97205-2512 | 2020-08-24 |
| 1386199461 | Kim E. Lucey Lcsw | Social Worker | 1020 Sw Taylor St Ste 700, Portland, OR 97205-2512 | 2016-08-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871026062 | Leila Soltani | Dentist | 430 Sw 13th Ave Apt 2010, Portland, OR 97205 | 2017-04-05 |
| 1114374949 | Elizabeth Alire | Counselor | 1411 Sw Morrison St., Portland, OR 97205 | 2016-05-23 |
| 1508237462 | Pacific Psychology and Comprehensive Health Center | Community/Behavioral Health | 1411 Sw Morrison Ave, Suite 310, Portland, OR 97205 | 2015-10-16 |
| 1265803761 | Alana Branson | Naturopath | 1033 Sw Yamhill Street, Suite 403, Portland, OR 97205 | 2015-10-10 |
| 1720458011 | Kate Ohene | Counselor | 1411 Sw Morrison Street, Suite 310, Portland, OR 97205 | 2015-09-30 |
| 1285004671 | Christina Nannette Mendoza | Counselor | 1411 Sw Morriston Street, 310, Portland, OR 97205 | 2015-09-29 |
| 1083095947 | Patricia Burton | Registered Nurse | 1312 Sw Washinghton, Portland, OR 97205 | 2015-06-16 |
| 1649663071 | Huey Holistic | Clinic/Center | 1221 Sw Yamill, Suite 300, Portland, OR 97205 | 2015-03-10 |
| 1376952796 | Joan Kendall Ayala | Counselor | 610 Sw Alder St Ste 915, Portland, OR 97205 | 2014-08-11 |
| 1316356165 | Satheara Sin | Massage Therapist | 1033 Sw Yamhill St. #403, Portland, OR 97205 | 2014-08-06 |
| Find all providers in zip 97205 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669082061 | Kelsey Miller | Marriage & Family Therapist | 5515 N Williams Ave, Portland, OR 97217-2452 | 2020-07-31 |
| 1255959631 | Veronica Terese Valdez | Marriage & Family Therapist | 4445 S Barbur Blvd Ste 205, Portland, OR 97239-4047 | 2020-07-11 |
| 1649896630 | Moving Forward Staying Present LLC | Marriage & Family Therapist | 8083 Se 13th Ave Ste 3, Portland, OR 97202-6668 | 2020-06-25 |
| 1669001723 | Jennifer Melissa Moss | Marriage & Family Therapist | 12356 Ne Brazee St, Portland, OR 97230-1841 | 2020-04-02 |
| 1174153225 | Amanda Fitzpatrick | Marriage & Family Therapist | 5410 Sw Macadam Ave Ste 250, Portland, OR 97239-3807 | 2020-01-16 |
| 1679114003 | Craig Cardamone Individual and Relational Therapy Pllc | Marriage & Family Therapist | 12 Kellogg St Apt 1, Portland, ME 04101-4375 | 2019-10-07 |
| 1538716816 | Ayala Parker | Marriage & Family Therapist | 3540 Sw Boundary St, Portland, OR 97221-3817 | 2019-08-21 |
| 1720648363 | Alicia Roshelle Turgesen | Marriage & Family Therapist | 835 Se Stephens St Ste 202, Portland, OR 97214-4636 | 2019-06-17 |
| 1194281477 | Shelbee Louise Leach Macomber | Marriage & Family Therapist | 1520 Westbrook St, Portland, ME 04102-1621 | 2019-02-12 |
| 1508335704 | Jacqueline Marie Mular | Marriage & Family Therapist | 5550 Sw Macadam Suite 100, Portland, OR 97239 | 2018-11-16 |
| 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.