ST MARY'S HOME FOR BOYS (NPI# 1619057098) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619057098 |
| Entity Type | Organization |
| Organization Name | ST MARY'S HOME FOR BOYS |
| Practice Address |
16535 Sw Tualatin Valley Hwy Beaverton OR 97006-5143 |
| Practice Telephone | 5036495651 |
| Practice Fax Number | 5036497405 |
| Mailing Telephone | 5036495651 |
| Mailing Fax Number | 5036497405 |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2013-05-07 |
| Authorized Official Name | MR. MICHAEL COLE (ASSISTANT DIRECTOR) |
| Authorized Official Telephone | 5032593201 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
OR | Behavioral Health & Social Service Providers | |
| N | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
891 | OR | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
891 | OR | Behavioral Health & Social Service Providers |
| N | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
891 | OR | Behavioral Health & Social Service Providers |
| N | 103T00000X | Psychologist | 891 | OR | Behavioral Health & Social Service Providers |
| N | 106H00000X | Marriage & Family Therapist | T0433 | OR | Behavioral Health & Social Service Providers |
| N | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
17887 | OR | Allopathic & Osteopathic Physicians |
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
OR | Ambulatory Health Care Facilities | |
| N | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | OR | Residential Treatment Facilities | |
| N | 283Q00000X | Psychiatric Hospital | 17887 | OR | Hospitals |
| Y | 103TC1900X |
Psychologist Specialization: Counseling |
891 | OR | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 210855 | 05 |
| Street Address |
16535 SW TUALATIN VALLEY HWY |
| City | BEAVERTON |
| State | OR |
| Zip Code | 97006-5143 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760039523 | Aundrea Hufana | Counselor | 16535 Sw Tualatin Valley Hwy, Beaverton, OR 97003-5143 | 2019-08-26 |
| 1922563444 | Heather Ashley Olson | Case Manager/Care Coordinator | 16535 Sw Tualatin Valley Hwy, Beaverton, OR 97003-5143 | 2019-02-08 |
| 1447724869 | Bryan Tommy Miller | Counselor | 16535 Sw Tualatin Valley Hwy, Beaverton, OR 97003-5143 | 2019-01-18 |
| 1366910390 | Joshua Yao Zheng | Case Manager/Care Coordinator | 16535 Sw Tualatin Valley Hwy, Beaverton, OR 97003-5143 | 2018-11-07 |
| 1912475070 | Ann Marie West | Case Manager/Care Coordinator | 16535 Sw Tualatin Valley Hwy, Beaverton, OR 97003-5143 | 2018-11-07 |
| 1568978070 | Scott Andrew Lagravinese | Case Manager/Care Coordinator | 16535 Sw Tualatin Valley Hwy, Beaverton, OR 97003-5143 | 2017-12-19 |
| 1447775481 | David Polansky | Social Worker | 16535 Sw Tualatin Valley Hwy, Beaverton, OR 97003-5143 | 2017-08-10 |
| 1285159491 | Melissa Ann Nini | Social Worker | 16535 Sw Tualatin Valley Hwy, Beaverton, OR 97003-5143 | 2017-08-08 |
| 1336664010 | Cristina Teresa Gonzales | Counselor | 16535 Sw Tualatin Valley Hwy, Beaverton, OR 97003-5143 | 2017-08-03 |
| 1831613017 | Patricia Yvette Laurance | Counselor | 16535 Sw Tualatin Valley Hwy, Beaverton, OR 97003-5143 | 2017-07-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184238727 | Hayden Alexander Meriwether | Dentist | 17895 Ne Evergreen Pkwy, #100, Beaverton, OR 97006 | 2020-09-01 |
| 1336781202 | Courtney Rae Murata | Behavior Technician | 337 Nw 215th Terrace, Apt, 106, Hillsboro, OR 97006 | 2019-10-11 |
| 1992355986 | Pamela J. Viado | Technician | 1220 Nw Weybridge Way, Beaverton, OR 97006 | 2019-09-12 |
| 1477115384 | One Change Group | Community/Behavioral Health | 2499 Nw 206th Ave, Apt A233, Hillsboro, OR 97006 | 2019-07-01 |
| 1649731332 | Regina C. Rizo | Social Worker | 1925 Amberglen Parkway, #3a-131, Hillsboro, OR 97006 | 2019-03-26 |
| 1043731912 | Elizabeth A Cintron | Occupational Therapy Assistant | 1189 Ne 89th Ave Apt 305, Hillsboro, OR 97006 | 2017-06-30 |
| 1265979173 | Lindsay Jensen | Massage Therapist | 15220 Nw Greenbrier Pkwy Ste 260, Beaverton, OR 97006 | 2017-01-30 |
| 1851835722 | Changepoint, Inc | Clinic/Center | 1700 Nw 167th Place, Suite 240, Beaverton, OR 97006 | 2016-12-13 |
| 1689126302 | Occupational Health Centers of The Southwest, P.a. (tx) | Clinic/Center | 2225 Nw Towncenter Drive, Beaverton, OR 97006 | 2016-10-28 |
| 1558717413 | Dillon Duvall | Physical Therapist | 16895 Nw Cornell Rd, #110, Beaverton, OR 97006 | 2016-05-10 |
| Find all providers in zip 97006 | ||||
| Taxonomy Code | 103TC1900X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Counseling |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336748771 | Sarah Lynn Livengood | Psychologist | 12655 Sw Center St Ste 100, Beaverton, OR 97005-1600 | 2020-10-17 |
| 1942374988 | Lisa Gabardi | Psychologist | 15455 Nw Greenbrier Pkwy, Suite 240, Beaverton, OR 97006-7374 | 2006-11-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932722345 | Izmirian Counseling, PC | Psychologist | 1450 Se Holgate Blvd, Portland, OR 97202-4717 | 2020-05-19 |
| 1538728472 | Little Star Psychological Services, LLC | Psychologist | 1127 Lincoln St, Eugene, OR 97401-3695 | 2019-06-12 |
| 1013573286 | Erin Fuller Crozier | Psychologist | 408 Sw Monroe Ave Ste M252, Corvallis, OR 97333-7210 | 2019-05-14 |
| 1225506702 | Michele Ribeiro | Psychologist | 511 Nw 11th St, Corvallis, OR 97330-6010 | 2018-11-02 |
| 1669959078 | Pamela Michelle Taite | Psychologist | 1785 Ne Sandy Blvd Ste 270, Portland, OR 97232-2791 | 2018-07-27 |
| 1861850737 | Traci Rieckmann | Psychologist | 2925 Ne 53rd Ave, Portland, OR 97213-2437 | 2016-02-05 |
| 1710370101 | Asha Stephen | Psychologist | 1590 E.13th Ave, Eugene, OR 97403 | 2015-03-10 |
| 1801289343 | Alisia Caban | Psychologist | 1590 E 13th Ave., University Counseling & Testing Center, Eugene, OR 97403-1280 | 2015-03-09 |
| 1336532860 | Heather Brooks Morse | Psychologist | 2228 West 25th Place, Eugene, OR 97405 | 2015-03-09 |
| 1073905758 | Brent Horner | Psychologist | 132 E Broadway Ste 301, Eugene, OR 97401-3154 | 2015-03-04 |
| Find all providers with the same taxonomy | ||||
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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.