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MARYJANE WILT LPC
NPI 1003106881
Counselor - Mental Health in Portland, OR

Active since April 13, 2011Opted out of Medicare · through Jul 29, 2028
212 NE 80TH AVE, PORTLAND, OR 97213(971) 255-1559(971) 255-0339 Get Directions Write a Review

NPPES record last updated: October 28, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Maryjane Wilt Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARYJANE WILT LPC (NPI 1003106881) is an individual mental health provider in Portland, Oregon, licensed in Oregon (C2002) and active in the NPI registry since April 2011. She has opted out of Medicare through July 29, 2028.

NPPES Registry Identity

NPI1003106881
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameMARYJANE WILTCredential: LPC
Location Address212 NE 80TH AVEPortland, OR 97213-7016
Mailing Address212 Ne 80th AvePortland, OR 97213-7016 · (971) 242-9322
Phone(971) 255-1559
Fax(971) 255-0339
Sole ProprietorNo
Enumeration DateApril 13, 2011
Last NPPES UpdateOctober 28, 2025
NPPES CertifiedOctober 28, 2025
✔ NPI 1003106881 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in OR · C2002
212 NE 80TH AVE, Portland, OR 97213
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include PacificSource Health Plans.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Maryjane Wilt Lpc has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 29, 2024 through July 29, 2028.

Opt-Out Effective DateJuly 29, 2024
Opt-Out In Effect ThroughJuly 29, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WELLBEING TRAILHEAD LLC
Counselor (Mental Health)
212 NE 80TH AVE
PORTLAND, OR 97213
Multnomah County (971) 888-2785

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Maryjane Wilt's NPI number?

The NPI number for Maryjane Wilt is 1003106881. It was assigned to this individual provider in the NPPES registry on April 13, 2011.

Where is Maryjane Wilt located?

Maryjane Wilt practices at 212 NE 80th Ave, Portland, OR 97213. The listed phone number is (971) 255-1559.

What is Maryjane Wilt's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Maryjane Wilt enrolled in Medicare?

No. Maryjane Wilt has opted out of Medicare through July 29, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

What insurance does Maryjane Wilt accept?

Health plans from PacificSource Health Plans list Maryjane Wilt as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Maryjane Wilt was last updated on October 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.