IMANI MENTAL HEALTH AND WELLNESS LLC
Nurse Practitioner (Psychiatric/Mental Health)

Address: 3939 Ne Hancock St # 202, Portland, OR 97212-5321

IMANI MENTAL HEALTH AND WELLNESS LLC (NPI# 1104415405) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1104415405
Entity Type Organization
Organization Name IMANI MENTAL HEALTH AND WELLNESS LLC
Practice Address 3939 Ne Hancock St # 202
Portland
OR 97212-5321
Practice Telephone 2144581713
Mailing Address 12063 Sw Taylor Ct
Portland
OR 97225-5845
Mailing Telephone 2144581713
Certification Date 2021-01-25
Enumeration Date 2021-01-12
Last Update Date 2021-01-25
Authorized Official Telephone 2144581713
Authorized Official Credential PMHNP-BC
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification Taxonomy Group License Number License State Taxonomy Group
Y 363LP0808X Nurse Practitioner
Specialization: Psychiatric/Mental Health
193400000X SINGLE SPECIALTY GROUP Physician Assistants & Advanced Practice Nursing Providers

Associated Endpoints

Endpoint Type Endpoint Affiliation Affiliation Address Use Content
CONNECT URL imanimentalhealthwellness@gmail.com (business email address) 3939 Ne Hancock St # 202, Portland, OR 972125321 Health Information Exchange (HIE) Other email

Office Location

Street Address 3939 NE HANCOCK ST # 202
City PORTLAND
State OR
Zip Code 97212-5321

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1003380478 Emily R Hinman Counselor · Professional 3939 Ne Hancock St Ste 209, Portland, OR 97212-5321 2019-01-17
1326548892 Forest Mountain Corporation Acupuncturist 3939 Ne Hancock St Ste 217, Portland, OR 97212-5321 2018-02-20
1932503539 Susan Mbugua Nurse Practitioner · Psychiatric/Mental Health 3939 Ne Hancock St Ste 202, Portland, OR 97212-5321 2014-10-10
1396056727 Nathan M Smith Nurse Practitioner · Psychiatric/Mental Health 3939 Ne Hancock St Ste Sf1, Portland, OR 97212-5321 2010-06-30
1205167160 Rebecca M Dodge Psychologist · Clinical 3939 Ne Hancock St # 316, Portland, OR 97212-5321 2010-01-15
1033353362 Peggy S. Nydahl Counselor · Professional 3939 Ne Hancock St Ste 117, Portland, OR 97212-5321 2009-04-30
1609014661 Tracie Jill Mccall Specialist 3939 Ne Hancock St Ste 307, Portland, OR 97212-5321 2009-01-29
1790815900 Mary Louise Miyakawa Social Worker · Clinical 3939 Ne Hancock St Ste 210, Portland, OR 97212-5321 2007-03-06
1538226386 Stephen R. Beck Social Worker 3939 Ne Hancock St # 302, Portland, OR 97212-5321 2007-01-02
1588765671 Catherine M Melo Social Worker · Clinical 3939 Ne Hancock St Ste 208, Portland, OR 97212-5321 2006-09-25
Find all providers in zip 97212-5321

Providers in the same zip code prefix

NPI Name Taxonomy Address Enumeration
1205423704 Oregon Cvs Pharmacy LLC Durable Medical Equipment & Medical Supplies 1821 Ne 33rd Avenue, Portland, OR 97212 2020-12-30
1497223051 Shira Dennis Behavior Analyst 3424 Ne Tillamook St., Portland, OR 97212 2018-11-12
1659890317 Cidnee Potter Doula 2915 Ne Mlk Jr Blvd, Portland, OR 97212 2017-09-14
1588194187 Ann M Staple Counselor · Mental Health 2905 Ne Tillamook St, Portland, OR 97212 2017-06-15
1780129502 Noelle Denise King Naturopath 2540 Ne Martin Luther King Jr Blvd Femelle Integrative, Suite A, Portland, OR 97212 2017-01-03
1285085100 Jessica Battin Massage Therapist 2310 Ne 8th Ave #2, Portland, OR 97212 2016-06-22
1316311830 Dr Elise Schroeder Clinic/Center 3531 Ne 15th Ave Suite A, Portland, OR 97212 2015-11-20
1467820738 Ayanna Askari Counselor · Addiction (Substance Use Disorder) 3655 N E Grand Ave, Portland, OR 97212 2015-09-03
1053797167 Iliana Henriquez Social Worker · School 3500 Ne Martin Luther King Blvd Suite 200, Portland, OR 97212 2015-07-31
1417346834 Emily Mcdonough Comerford Case Manager/Care Coordinator 1823 Ne 8th Avenue, Kinship House, Portland, OR 97212 2015-01-22
Find all providers in zip 97212

Taxonomy Information

Taxonomy Code 363LP0808X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Psychiatric/Mental Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1154920148 Hardcore Happy LLC 740 Ne 116th Ct, Portland, OR 97220-2223 2020-10-20
1457967325 Megan L Langworthy 1914 Se 46th Ave, Portland, OR 97215-3148 2020-09-16
1104446681 Skycloud Psychiatry LLC 106 South West Woods St, Portland, OR 97201 2020-04-24
1730712290 Lucy Anne Bloedon 4020 Sw Iowa St, Portland, OR 97221-3423 2020-02-12
1346802733 Compass Psychiatric Wellness LLC 4300 Ne Fremont St Ste 260, Portland, OR 97213-1100 2019-07-05
1548721871 Cooke Therapy Pllc 1125 Se Madison St Ste 102, Portland, OR 97214-3600 2019-03-28
1245719541 Scott J Whited 216 Vaughan St., Mcgeachy Hall, Portland, ME 04101 2018-08-08
1467969220 Nw Mind-Body Wellness, LLC 16986 Nw Lynch Ln, Portland, OR 97229-1221 2018-01-02
1811441348 Anthony Hoy 5562 Se Pine St, Portland, OR 97215-1276 2016-08-12
1700241254 Jacqueline J Cole · Jacqueline J Rhatican 5228 Ne Hoyt St Ste 300, Portland, OR 97213-3055 2015-12-29
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Competitor

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City PORTLAND
Zip Code 97212

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Dataset Information

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.