NEW LEAVES CLINIC LLC (NPI# 1649475641) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649475641 |
| Entity Type | Organization |
| Organization Name | NEW LEAVES CLINIC LLC |
| Practice Address |
200 Sw Market St Ste #390 Portland OR 97201 |
| Mailing Address |
5319 Sw Westgate Dr #241 Portland OR 97221-2432 |
| Practice Telephone | 5032740996 |
| Mailing Telephone | 5032977223 |
| Mailing Fax Number | 5032977603 |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. CYNTHIA LYNNE ARNOLD (OWNER) |
| Authorized Official Telephone | 5032740996 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | 1594 | OR | Behavioral Health & Social Service Providers |
| Y | 103T00000X | Psychologist | 1620 | OR | Behavioral Health & Social Service Providers |
| Street Address |
200 SW MARKET ST STE #390 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780782193 | Andrea Olsen D'ostroph | Ophthalmology | 200 Sw Market St, Suite L-120, Portland, OR 97201-5715 | 2006-09-20 |
| 1376707984 | Anna R Anderson | Optometrist | 200 Sw Market St, #l120, Portland, OR 97201-5715 | 2008-07-12 |
| 1245439553 | Terrence Joseph Olson | Preferred Provider Organization | 200 Sw Market St, East 9 A, Portland, OR 97201-5715 | 2007-07-16 |
| 1760523831 | Ralph Merrill Prows | Internal Medicine | 200 Sw Market St, Mail Stop E12a, Portland, OR 97201-5715 | 2007-02-09 |
| 1306916457 | Avrel Nudelman | Optometrist | 200 Sw Market St, Suite L120, Portland, OR 97201-5715 | 2006-11-08 |
| 1689772014 | Joseph P Meurer Jr Md | Durable Medical Equipment & Medical Supplies | 200 Sw Market St, Suite L-120, Portland, OR 97201-5715 | 2006-09-20 |
| 1770681132 | Eye Group Associates PC | Ophthalmology | 200 Sw Market St, Suite L-120, Portland, OR 97201-5715 | 2006-09-20 |
| 1144328592 | Gary A Grieve | Ophthalmology | 200 Sw Market St, Suite L-120, Portland, OR 97201-5715 | 2006-09-20 |
| 1598863938 | Joseph P Meurer | Ophthalmology | 200 Sw Market St, Suite L-120, Portland, OR 97201-5715 | 2006-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780206060 | Laura Elizabeth Jackson | Student in an Organized Health Care Education/Training Program | 2730 S Moody Ave, Portland, OR 97201 | 2020-05-10 |
| 1225659063 | Amanpreet Kaur | Student in an Organized Health Care Education/Training Program | Ohsu Physician Assistant Program, 2730 South Moody Ave. Mail Code: Cl5pa, Portland, OR 97201 | 2020-05-04 |
| 1063033801 | Aaron Kinn | Student in an Organized Health Care Education/Training Program | Ohsu Division of Physician Assistant Education - Cl5pa, 2730 Sw Moody Avenue, Portland, OR 97201 | 2020-05-04 |
| 1487275442 | Erin Aleen Ostlie-madden | Student in an Organized Health Care Education/Training Program | 2730 South Moody Ave, Portland, OR 97201 | 2020-04-30 |
| 1104446681 | Skycloud Psychiatry LLC | Nurse Practitioner | 106 South West Woods St, Portland, OR 97201 | 2020-04-24 |
| 1740825587 | Dalia Bayaa | Pharmacist | 325 Sw Harrison Street, Portland, OR 97201 | 2019-11-15 |
| 1780172619 | Susan Elizabeth Christian Barrios | Social Worker | 1505 Sw College St, Portland, OR 97201 | 2018-04-26 |
| 1730696576 | Fiona Everett | Counselor | 1703 Sw Clay St, Portland, OR 97201 | 2018-01-02 |
| 1437678844 | Akira Thomas Neilsen | Student in an Organized Health Care Education/Training Program | 1930 Sw River Drive, Unit 102, Portland, OR 97201 | 2017-09-18 |
| 1285171736 | Howard Mitchell | Technician, Other | 1110 Sw Clay Street Apt. 34, Portland, OR 97201 | 2017-01-23 |
| Find all providers in zip 97201 | ||||
| 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 |
|---|---|---|---|---|
| 1508466574 | Jessica Michelle Simonetti | Psychologist | Portland Psychotherapy Clinic, Research and Training Ce, 3700 N Williams Ave, Portland, OR 97227 | 2020-10-29 |
| 1811518434 | Nathaniel Israel | Psychologist | 7419 Se Woodstock Blvd, Portland, OR 97206-5838 | 2020-05-05 |
| 1477112480 | Stella Beatriz Kerl-mcclain | Psychologist | 2826 Sw Ridge Dr, Portland, OR 97219-6205 | 2019-06-12 |
| 1184281438 | Nicholas Alexander Schollars | Psychologist | 3050 Se Division St # 215, Portland, OR 97202-1451 | 2019-05-22 |
| 1639637432 | Bayside Psychology and Consulting, LLC | Psychologist | 1 Union St Ste 402, Portland, ME 04101-4048 | 2019-03-11 |
| 1942766985 | Alexandra R. Lash | Psychologist | 386 Fore St, Portland, ME 04101-4047 | 2019-02-14 |
| 1811416068 | Matthew Lundeberg | Psychologist | 10300 Sw Greenburg Rd Ste 271, Portland, OR 97223-5415 | 2017-09-19 |
| 1083130991 | Tawayne Nolen Malone Jr. | Psychologist | 0615 Sw Palatine Hill Road, Tawayne Malone - Msc 2159, Portland, OR 97219 | 2017-08-22 |
| 1093241838 | Dr Patricia Clark | Psychologist | 1132 Sw 19th Ave, Portland, OR 97205-1740 | 2017-05-11 |
| 1639527575 | Randall David Wright | Psychologist | 1827 Ne 44th Ave Ste 320, Portland, OR 97213-1443 | 2016-06-01 |
| 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.