KEVIN C. MIYASATO (NPI# 1184902504) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184902504 |
| Entity Type | Individual |
| Full Name | KEVIN C. MIYASATO |
| Credential | LCSW |
| Practice Address |
12725 Sw Millikan Way Suite 300 Beaverton OR 97005-1678 |
| Practice Telephone | 5039067870 |
| Practice Fax Number | 5039067871 |
| Mailing Telephone | 5039067870 |
| Mailing Fax Number | 5039067871 |
| Enumeration Date | 2011-08-02 |
| Last Update Date | 2014-06-06 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
00686 | NV | Behavioral Health & Social Service Providers |
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
5855 | OR | Behavioral Health & Social Service Providers |
| N | 1041C0700X |
Social Worker Specialization: Clinical |
5214-S | NV | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 500670052 | 05 |
| Street Address |
12725 SW MILLIKAN WAY SUITE 300 |
| City | BEAVERTON |
| State | OR |
| Zip Code | 97005-1678 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114907144 | Sabine Clara Meyer | Psychiatry & Neurology | 12725 Sw Millikan Way, Ste 300, Beaverton, OR 97005-1687 | 2006-01-17 |
| 1093168700 | Senior Psychiatric Services | Psychiatry & Neurology | 12725 Sw Millikan Way, Suite 300, Beaverton, OR 97005-1678 | 2016-07-18 |
| 1104236819 | A Healing Intention, LLC | Community/Behavioral Health | 12725 Sw Millikan Way, Suite 300, Beaverton, OR 97005-1678 | 2014-05-02 |
| 1104158112 | Terri L Mishler Psy D PC | Psychologist | 12725 Sw Millikan Way, Suite 280, Beaverton, OR 97005-1678 | 2010-02-02 |
| 1992854947 | Pjs, LLC | Clinic/Center | 12725 Sw Millikan Way, Suite 300, Beaverton, OR 97005-1678 | 2007-01-09 |
| 1639109895 | Terri Lynn Mishler | Psychologist | 12725 Sw Millikan Way, Suite 280, Beaverton, OR 97005-1678 | 2006-07-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154945053 | Krista Lowe Schimmelbusch | Student in an Organized Health Care Education/Training Program | 12730 Sw 3rd St., Beaverton, OR 97005 | 2020-06-05 |
| 1346882578 | Mireya Elissa Nunez I | Counselor | 12665 Sw Center Street, Suite 100, Beaverton, OR 97005 | 2019-10-09 |
| 1548816879 | Logan James Patzlaff | Behavior Technician | 6200 Sw Artic Drive Beaverton, Or 97005, Beaverton, OR 97005 | 2019-08-13 |
| 1528521424 | Alex Taylor Foerman | Behavior Technician | 6200 Sw Arctic Drive Beaverton, Or 97005, Beaverton, OR 97005 | 2019-04-09 |
| 1285193003 | Hazelnut Dental LLC | Clinic/Center | 10773 Sw Beaverton-hillsdale Hwy, Ste B, Beaverton, OR 97005 | 2019-03-19 |
| 1992286348 | Kathryn Wallner | Counselor | 14205 Sw Farmington Road, Suite 160, Beaverton, OR 97005 | 2018-08-23 |
| 1699265058 | Meaghan Mikulic | Social Worker | 14355 Sw Allen Blvd Suite 150, Beaverton, OR 97005 | 2018-05-11 |
| 1629568936 | Aimee J Nelson | Massage Therapist | 10700 Sw Beaverton Hillsdale Hwy Ste 465, Beaverton, OR 97005 | 2018-05-11 |
| 1093221780 | Ember Dahl | Massage Therapist | 12655 Sw Center St Ste 530, Beaverton, OR 97005 | 2017-12-18 |
| 1033667456 | Andre Vo | Pharmacist | 2575 Sw Walker Rd, Beaverton, OR 97005 | 2016-09-14 |
| Find all providers in zip 97005 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457811887 | Gareth Robert Smith | Social Worker | 14825 Sw Farmington Rd, Beaverton, OR 97007-2724 | 2019-03-21 |
| 1003373101 | Carla E Fadriquela | Social Worker | 2980 Sw 123rd Ave, Beaverton, OR 97005-1325 | 2019-02-25 |
| 1144795477 | Madilyn Long | Social Worker | 4900 Sw Griffith Dr Ste 249, Beaverton, OR 97005-4648 | 2018-10-13 |
| 1689058794 | Susan Driver | Social Worker | 14631 Sw Millikan Way # 8, Beaverton, OR 97003-2999 | 2015-07-17 |
| 1740615848 | Krystal Karin Ashling | Social Worker | 4895 Sw Normandy Pl, 4895 Sw Normandy Place, Beaverton, OR 97005 | 2013-09-08 |
| 1174825350 | Debbie Yoro | Social Worker | 10700 Sw Beaverton Hillsdale Hwy Ste 560, Beaverton, OR 97005-4791 | 2010-11-22 |
| 1679883383 | Pamela Lynn Mottola | Social Worker | 14255 Sw Brigadoon Court, Beaverton, OR 97005 | 2010-10-15 |
| 1134434061 | Emily Kirsten Haug | Social Worker | 15455 Nw Greenbrier Pkwy Ste 112, Beaverton, OR 97006-8115 | 2010-08-16 |
| 1497994115 | Janice Eaton-bennette | Social Worker | 3900 Sw Murray Blvd Ste 100, Beaverton, OR 97005-2454 | 2009-02-19 |
| 1790922235 | Kelly Lynn Gilmore | Social Worker | 8285 Sw Nimbus Ave Ste 148, Beaverton, OR 97008-6465 | 2009-01-20 |
| Find all providers in BEAVERTON | ||||
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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.