MIXTLY SIMON-BEARD (NPI# 1144815630) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144815630 |
| Entity Type | Individual |
| Full Name | MIXTLY SIMON-BEARD |
| Gender | Female |
| Practice Address | 3415 Se Powell Blvd Portland OR 97202-3371 |
| Practice Telephone | 5032349591 |
| Mailing Address | 3415 Se Powell Blvd Portland OR 97202-3371 |
| Mailing Telephone | 5032349591 |
| Certification Date | 2021-03-05 |
| Enumeration Date | 2021-03-05 |
| Last Update Date | 2021-03-05 |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | Group | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| Street Address | 3415 SE POWELL BLVD |
| City | PORTLAND |
| State | OR |
| Zip Code | 97202-3371 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346833027 | Casey Morgan Lowrey | Behavior Technician | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2021-02-14 |
| 1013509009 | Karina Maria Pacheco | Case Manager/Care Coordinator | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2021-02-10 |
| 1659963643 | Merel Burleigh Jacobs | Counselor | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2021-02-10 |
| 1518556653 | Kiersten Gilbert | Counselor | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2021-01-13 |
| 1891383337 | Quin Wogmon | Counselor | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2021-01-08 |
| 1962099549 | Lyn King | Counselor · Professional | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2020-12-29 |
| 1154918050 | Rylie Szolomayer | Counselor | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2020-12-26 |
| 1760079750 | Sebastian Perez | Counselor | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2020-12-24 |
| 1215523774 | Phillip Kent | Social Worker · School | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2020-12-17 |
| 1346836996 | Deserina Martinez | Counselor | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2020-12-17 |
| Find all providers in the same address | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659769594 | Elan Eichler | Social Worker | 3415 Se Powell, Portland, OR 97202-3371 | 2014-12-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073143442 | Carewell LLC | Counselor · Mental Health | Portland River Park Center, 205 Se Spokane St Suite 358, Portland, OR 97202 | 2020-01-24 |
| 1629627997 | Ben Carlstrom | Speech-Language Pathologist | 3320 Se Holgate Blvd, Portland, OR 97202 | 2019-09-09 |
| 1588226765 | Melissa Lynn Hartley | Counselor · Mental Health | 1235 Se Division St. Suite 103, Portland, OR 97202 | 2019-07-08 |
| 1275192999 | Kimberly Rae Kilgore | Counselor | 5509 Se 22nd St #3a, Portland, OR 97202 | 2019-06-06 |
| 1154988871 | Hannah Mary Vestal | Counselor · Mental Health | 1818 Se Division St, Portland, OR 97202 | 2019-05-29 |
| 1255998167 | Jeniffer White | Behavior Technician | 205 Se Spokane St Ste 329, Portland, OR 97202 | 2019-05-26 |
| 1639736069 | Kyra Steinhauer | Social Worker | 3145 Se Powell Blvd, Portland, OR 97202 | 2019-05-21 |
| 1437634151 | Danielle Briana-Hansen Nix · Daniella Briana Hansen | Massage Therapist | 1222 Se Division St, Portland, OR 97202 | 2018-09-27 |
| 1922591387 | Rene J Rice | Social Worker · Clinical | 1438 Se Division St, Portland, OR 97202 | 2018-06-11 |
| 1538662168 | Abigail Annie Buckles · Abigail Annie Druffel | Student in an Organized Health Care Education/Training Program | 2740 Se Powell Blvd, Portland, OR 97202 | 2018-03-09 |
| Find all providers in zip 97202 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538754056 | Emil Tristan Marz | 2445 Se Hawthorne Blvd, Portland, OR 97214-3924 | 2021-03-05 | |
| 1609461763 | Serena M Fonte | 1904 Se Division St, Portland, OR 97202-1146 | 2021-03-01 | |
| 1922691443 | Heather Richards | 125 Presumpscot St Unit 9, Portland, ME 04103-5299 | 2021-02-16 | |
| 1013509041 | Patrick Tyler Bluett | 8083 Se 13th Ave Ste 3, Portland, OR 97202-6668 | 2021-02-10 | |
| 1659963643 | Merel Burleigh Jacobs | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2021-02-10 | |
| 1295326262 | David Burnell | 3650 Ne Mallory Ave Apt 101, Portland, OR 97212-3088 | 2021-02-01 | |
| 1720678576 | Alexa Durkin-Tang | 14600 Nw Cornell Rd, Portland, OR 97229-5442 | 2021-01-25 | |
| 1790375947 | Alison Lentz | 1507 Ne 122nd Ave, Portland, OR 97230-1911 | 2021-01-21 | |
| 1518556653 | Kiersten Gilbert | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2021-01-13 | |
| 1891383337 | Quin Wogmon | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2021-01-08 | |
| Find all providers in PORTLAND | ||||
| City | PORTLAND |
| Zip Code | 97202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942821566 | Simon Eyes, Inc. | Ophthalmology | 3260 Beard Rd Ste 5, Napa, CA 94558-3466 | 2020-05-05 |
| 1891874525 | Simon & Simon Dds · Herbert Simon Dds and Carol Simon Dds Partners | Dentist | 2840 Delaware Avenue, 2nd Floor, Kenmore, NY 14217 | 2006-11-03 |
| 1598365504 | James Louis Beard · Jim Beard | Pharmacist | 1110 Battleground Dr, Iuka, MS 38852-1021 | 2020-10-28 |
| 1033237318 | Dr Darryll L Beard Dmd Ltd · Drs Beard & Holmen Ltd | Dentist · General Practice | 208 Bradford Lane, Waterloo, IL 62298 | 2007-03-26 |
| 1306900543 | Mildred J. Beard · Jean Beard | Licensed Practical Nurse | 1319 Saul Rd, Sunnyside, WA 98944-2300 | 2006-12-21 |
| 1104107820 | Rha Health Services Nc, LLC · 365 Beard | Community/Behavioral Health | 1205 Beard St, Salisbury, NC 28144-3866 | 2011-09-08 |
| 1306852223 | Barbara Beard Barnett · Barbara Lynn Beard | Physical Therapist | 7065 Airways Blvd, Suite 110, Southaven, MS 38671-5873 | 2006-07-31 |
| 1346216959 | Leslie Beard Miller · Leslie Gayle Beard | Optometrist | 1555 Highlands Dr, Suite 180, Lititz, PA 17543-2800 | 2006-02-23 |
| 1093721268 | James P. Beard · James P. Beard | Chiropractor | 1920 W Bay Dr Ste 1, 1560 Parkview Lane (home), Largo, FL 33770-3022 | 2006-07-31 |
| 1215061627 | Hillard L Torgan Dds, Bruce F Beard Dds, Manuel J Fernandez IIi Dds · Beard Fernandez Dental Group | Dentist | 22600 Ventura Blvd, Suite 204, Woodland Hills, CA 91364-1414 | 2007-03-15 |
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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.