SPROUT THERAPY PDX LLC


Address: 7704 N Hereford Ave, Portland, OR 97203-3434
Phone: 9713194827

SPROUT THERAPY PDX LLC (NPI# 1093346777) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1093346777
Entity Type Organization
Organization Name SPROUT THERAPY PDX LLC
Practice Address 7704 N Hereford Ave
Portland
OR 97203-3434
Mailing Address 6012 N Villard Ave
Portland
OR 97217-4039
Practice Telephone 9713194827
Practice Fax Number 5036626220
Mailing Telephone 2068908045
Mailing Fax Number 5036626220
Enumeration Date 2020-01-30
Last Update Date 2020-01-30
Authorized Official Name EMELIE ANGELINA BLANK (OWNER & LEAD CLINICAN)
Authorized Official Telephone 9713194827
Authorized Official Credential LPC
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101Y00000X Counselor Behavioral Health & Social Service Providers

Other Provider/Organization Names

Other Name Type Code
Sprout Therapy PDX Doing Business As Name - Organization

Other Data Sources

Entity Type Entity Name Entity Address
Oregon Corporations, Companies and Business Names SPROUT THERAPY PDX LLC 7704 N Hereford Ave, Portland, OR 97203

Office Location

Street Address 7704 N HEREFORD AVE
City PORTLAND
State OR
Zip Code 97203-3434

Providers in the same location

NPI Name Taxonomy Address Enumeration
1710592365 Arlyne Soto Counselor 7704 N Hereford Ave, Portland, OR 97203-3434 2020-09-10
1750993051 Monika Weitzel Social Worker 7704 N Hereford Ave, Portland, OR 97203-3434 2020-08-18

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1952923757 Justin Cummings Meals 10105 N. Oswego Ave, Portland, OR 97203 2020-05-14
1407335045 Gage Solis Student in an Organized Health Care Education/Training Program 8425 N. Lombard St, Portland, OR 97203 2018-08-13
1497103493 Ruby Diane Ciarlante Community Health Worker 7803 N Portsmouth Ave, Portland, OR 97203 2016-05-31
1992139620 Hannah Clare Speech-Language Pathologist 7126 N Amherst St, Portland, OR 97203 2013-08-29
1043656713 Heather Ranae Mcintosh Social Worker 7323 N Burlington Ave, Portland, OR 97203 2013-05-21
1275879363 Matthew Scott Bennett Pharmacist 6850 N. Lombard, Portland, OR 97203 2012-12-18
1144594094 Candice Juliet Thomas Pharmacist 9000 N. Lombard St, Portland, OR 97203 2012-02-23
1093013211 Aarisa Elysianne Smith Mechanotherapist 8438 N Lombard St, Ste 7, Portland, OR 97203 2011-03-11
1700103546 Lisa Catherine Davis Acupuncturist 1614 Ne Alberta Street, Portland, OR 97203 2010-05-03
1427298579 Donald Marvin Lorenzen Denturist 8530 N. Ivanhoe, Portland, OR 97203 2009-03-03
Find all providers in zip 97203

Taxonomy Information

Taxonomy Code 101Y00000X
Grouping Behavioral Health & Social Service Providers
Classification Counselor

Taxonomy Definition

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification.
Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1104427160 Kristine Lee Jones Counselor 2628 Se 87th Ave, Portland, OR 97266-1530 2020-11-05
1932711322 Rachel Wilson Counselor 1020 Se 7th Ave # 14283, Portland, OR 97214-2387 2020-08-18
1851919906 Anjana Rajan Counselor Lifeworks Northwest, 14600 Nw Cornell Rd, Portland, OR 97229 2020-07-06
1972124196 Outside In Counselor 16144 E Burnside St, Portland, OR 97233-3520 2020-04-28
1962022350 Nicole Blake Counselor 400 Commercial St, Portland, ME 04101-4660 2020-04-25
1912527201 Alexa Jenkins Counselor 2700 Se Stark St Apt 3, Portland, OR 97214-3499 2020-04-16
1467086629 Katelan Ruby Hostetler Counselor 13300 Ne San Rafael St, Portland, OR 97230-3123 2020-02-26
1356973770 Laura Kille Counselor Wise Counsel and Comfort, 2045 Se Hawthorne Blvd., Portland, OR 97214 2020-02-05
1861030553 Steve Bijoga Counselor 1350 Forest Ave Apt 16, Portland, ME 04103-1815 2019-12-13
1962043521 Ladan Radafshar Counselor 1017 Sw Morrison St Ste 315, Portland, OR 97205-2628 2019-10-04
Find all providers in PORTLAND

Competitor

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City PORTLAND
Zip Code 97203

Improve Information

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Dataset Information

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.

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