SERENDIB PSYCHOLOGICAL SERVICES, LLC (NPI# 1275132979) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275132979 |
| Entity Type | Organization |
| Organization Name | SERENDIB PSYCHOLOGICAL SERVICES, LLC |
| Practice Address |
14523 Westlake Dr Lake Oswego OR 97035-7700 |
| Practice Telephone | 9713730415 |
| Practice Fax Number | 9713338352 |
| Mailing Telephone | 9713730415 |
| Mailing Fax Number | 9713338352 |
| Enumeration Date | 2020-10-22 |
| Last Update Date | 2020-11-01 |
| Authorized Official Name | DR. KUSHANTHI SURINI SAMARATUNGE (OWNER) |
| Authorized Official Telephone | 9713730415 |
| Authorized Official Credential | PSY.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | Behavioral Health & Social Service Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | SERENDIB PSYCHOLOGICAL SERVICES, LLC | 14523 Westlake Dr, Lake Oswego, OR 97035 |
| Street Address |
14523 WESTLAKE DR |
| City | LAKE OSWEGO |
| State | OR |
| Zip Code | 97035-7700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548247075 | David K White | Psychiatry & Neurology | 14523 Westlake Dr, Suite 8, Lake Oswego, OR 97035-7700 | 2005-12-27 |
| 1689110868 | Portland Integrative Psychiatry | Nurse Practitioner | 14523 Westlake Dr, 4, Lake Oswego, OR 97035-7700 | 2017-01-12 |
| 1619411352 | Corinne Henderson | Social Worker | 14523 Westlake Dr, Suite 8, Lake Oswego, OR 97035-7700 | 2016-12-15 |
| 1952799637 | Jacqueline Bradford | Counselor | 14523 Westlake Dr, Suite 23, Lake Oswego, OR 97035-7700 | 2015-01-02 |
| 1669876173 | Medstar Nw, LLC | Durable Medical Equipment & Medical Supplies | 14523 Westlake Dr, Lake Oswego, OR 97035-7700 | 2014-10-13 |
| 1912264870 | Elizabeth Hawkins | Psychologist | 14523 Westlake Dr, Lake Oswego, OR 97035-7700 | 2012-04-17 |
| 1063536258 | Johanna Courtleigh | Counselor | 14523 Westlake Dr, Lake Oswego, OR 97035-7700 | 2007-03-16 |
| 1275696098 | Garen Leeann Weitman | Psychologist | 14523 Westlake Dr, Lake Oswego, OR 97035-7700 | 2006-12-19 |
| 1164503462 | Mary Moffit | Psychologist | 14523 Westlake Dr, Lake Oswego, OR 97035-7700 | 2006-10-17 |
| 1235227240 | Gregg Steven Sashkin | Psychologist | 14523 Westlake Dr, Suite 11, Lake Oswego, OR 97035-7700 | 2006-10-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932700127 | Teresa Siebenaler Scott | Social Worker | 3990 Sw Collins Way, Suite 202, Lake Owsego, OR 97035 | 2020-11-04 |
| 1528671567 | Martin Henry Lees | Internal Medicine | 14 Morningview Lane, Lake Oswego, OR 97035 | 2020-08-28 |
| 1356976187 | Premere Rehab LLC | Occupational Therapist | Infinity Rehab - The Springs At Lake Oswego, 3900 Kruse Way Pl, Lake Oswego, OR 97035 | 2020-03-12 |
| 1689212193 | Jennifer Chauvin | Nurse Practitioner | 20 Juarez Street, Lake Oswego, OR 97035 | 2019-12-16 |
| 1003396888 | Sarah Guenzburger | Physical Therapist | 3900 Kruse Way Pl, Lake Oswego, OR 97035 | 2018-08-21 |
| 1568964252 | Brett Johnson | Marriage & Family Therapist | 5655 Southwood Dr, Lake Oswego, OR 97035 | 2018-03-08 |
| 1912416561 | Michael Paul Long | Social Worker | 14523 Westlake Drive, Lake Oswego, Or 97035, Lake Oswego, OR 97035 | 2017-09-27 |
| 1467807859 | Misty Lohn | Nurse Practitioner | 5 Centerpointe Dr., Ste 600, Lake Oswego, OR 97035 | 2016-05-04 |
| 1326405473 | Kelsey Prince | Behavioral Analyst | 6400 Sw Rosewood St., Portland (lake Oswego), OR 97035 | 2016-01-20 |
| 1942683388 | Elizabeth Risberg Harrison | Massage Therapist | 190 Oswego Summit, Lake Oswego, OR 97035 | 2015-07-02 |
| Find all providers in zip 97035 | ||||
| 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 |
|---|---|---|---|---|
| 1235417700 | Paul M. Guinther | Psychologist | 14523 Westlake Dr # 15, Lake Oswego, OR 97035-7700 | 2011-08-01 |
| 1508027111 | Trude Zmoelnig | Psychologist | 668 Mcvey Ave, 123, Lake Oswego, OR 97034-4853 | 2008-06-17 |
| 1356478051 | Nancy J Lamb | Psychologist | 425 Sw Second St., Suite 200, Lake Oswego, OR 97034 | 2007-02-28 |
| 1992830376 | Melinda Byrd | Psychologist | 14523 Westlake Drive, Suite 5, Lake Oswego, OR 97035-7700 | 2007-02-23 |
| 1851430276 | R. Scott Palmer | Psychologist | 155 B Ave Ste 220, Lake Oswego, OR 97034-3180 | 2007-02-05 |
| 1932295821 | Matthew J Modrcin IIi | Psychologist | 420 S State St, Lake Oswego, OR 97034-3938 | 2006-10-05 |
| 1982791745 | Marci J Nemhauser | Psychologist | 4800 Sw Meadows Rd, Suite 300, Lake Oswego, OR 97035 | 2006-10-05 |
| 1720051980 | David William Katz | Psychologist | 4550 Kruse Way, Suite 225, Lake Oswego, OR 97035-3594 | 2006-02-08 |
| 1952380982 | Darrel Worthley Eacret | Psychologist | 15964 Lwr. Boones Ferry Rd., Suite 103, Lake Oswego, OR 97035-4361 | 2006-01-10 |
| 1487047007 | Psych Nw, PC | Psychologist | 17704 Jean Way Ste 105, Lake Oswego, OR 97035-5586 | 2015-03-05 |
| Find all providers in LAKE OSWEGO | ||||
| City | LAKE OSWEGO |
| Zip Code | 97035 |
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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.