HOLISTIC COMMUNITY THERAPY LLC (NPI# 1073179776) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073179776 |
| Entity Type | Organization |
| Organization Name | HOLISTIC COMMUNITY THERAPY LLC |
| Practice Address |
4339 Ne 115th Ave Portland OR 97220-1409 |
| Practice Telephone | 7202974572 |
| Mailing Telephone | 5038820988 |
| Enumeration Date | 2019-05-17 |
| Last Update Date | 2020-08-09 |
| Authorized Official Name | DR. ELIZABETH MARTIN (OCCUPATIONAL THERAPIST) |
| Authorized Official Telephone | 7202974572 |
| Authorized Official Credential | OTD, MHA, OTR/L |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251E00000X | Home Health | Agencies | ||
| N | 225XN1300X |
Occupational Therapist Specialization: Neurorehabilitation |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | HOLISTIC COMMUNITY THERAPY LLC | 4339 Ne 115th Ave, Portland, OR 97220-1409 |
| Oregon Corporations, Companies and Business Names | HOLISTIC COMMUNITY THERAPY LLC | 4339 Ne 115th Ave, Portland, OR 97220 |
| Street Address |
4339 NE 115TH AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97220-1409 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790225712 | Elizabeth Martin | Occupational Therapist | 4339 Ne 115th Ave, Portland, OR 97220-1409 | 2017-02-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316569254 | Debra Shamblin | Behavioral Analyst | 150 Ne 100th Ave, Portland, OR 97220 | 2020-05-14 |
| 1336780618 | Joan Lambert | Technician | 2802 Ne 108th Avenue, Portland, OR 97220 | 2019-10-08 |
| 1750933917 | Multnomah County | Clinic/Center | 11540 Ne Inverness Dr., Inverness Jail, Portland, OR 97220 | 2019-07-09 |
| 1194223107 | Landmark Connect of Oregon PC | General Practice | 5933 Ne Win Sivers Dr Ste 310, Portland, OR 97220 | 2018-01-24 |
| 1487178711 | Andrew Shonk | Massage Therapist | 163 Ne 102nd Ave Blid V, Portland, OR 97220 | 2017-07-28 |
| 1548781693 | Greater New Hope Family Services | Lodging | 11868 Ne Sandy Blvd, Portland, OR 97220 | 2017-06-29 |
| 1245771740 | Maria Teresa Banez Salcedo | Registered Nurse | 10300 Ne Hancock Street, Portland, OR 97220 | 2017-03-16 |
| 1568901858 | Christopher Gabriel Lyons | Adult Companion | 1343 Ne 118 Ave. Apt5, Portland, OR 97220 | 2017-02-20 |
| 1962945956 | Linda Ann Oldenburg | Registered Nurse | 9515 Ne Skidmore Avenue, Portland, OR 97220 | 2016-11-23 |
| 1326493446 | Trent D. Wilson | Massage Therapist | 8401 Ne Halsey St., Suite 101, Portland, OR 97220 | 2016-04-26 |
| Find all providers in zip 97220 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710586821 | Plum Consulting LLC | Community/Behavioral Health | 1161 Nw Overton St Apt 1501, Portland, OR 97209-2549 | 2020-10-20 |
| 1790302677 | Hope for All Community Services LLC | Community/Behavioral Health | 68 Bishop St, Building 1, Unit 1, Portland, ME 04103 | 2020-06-26 |
| 1184247850 | Altoris Behavior Support LLC | Community/Behavioral Health | 3880 Se 8th Ave Ste 105, Portland, OR 97202-3772 | 2020-05-28 |
| 1619599636 | Rivers Way Training Clinic | Community/Behavioral Health | 2049 Nw Hoyt, Portland, OR 97209 | 2020-05-13 |
| 1578102216 | Act Nw | Community/Behavioral Health | 909 Nw 24th Ave, Portland, OR 97210-3009 | 2019-12-28 |
| 1194284349 | Oriel Offit, Clinical Psychologist, LLC | Community/Behavioral Health | 222 Saint John St Ste 227, Portland, ME 04102-3058 | 2019-03-18 |
| 1396210977 | Ask Counseling LLC | Community/Behavioral Health | 8885 Sw Canyon Rd Ste 108, Portland, OR 97225-3431 | 2018-10-10 |
| 1790260313 | Bernard J. Gordon Md Pa LLC | Community/Behavioral Health | 145 Newbury St Fl 1, Portland, ME 04101-4261 | 2018-09-28 |
| 1497235576 | Saturn Supports LLC | Community/Behavioral Health | 3228 Sw Beaverton Hillsdale Hwy Apt 23, Portland, OR 97239-1193 | 2018-08-17 |
| 1770063067 | Nami Multnomah | Community/Behavioral Health | 524 Ne 52nd Ave, Portland, OR 97213-3047 | 2018-08-16 |
| 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.