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DR. GENEVIEVE PRUNEAU PHD
NPI 1063751410
Psychologist - Clinical in Portland, OR

Active since February 05, 2013Opted out of Medicare · through Jun 18, 2027
3808 N WILLIAMS AVE STE F, PORTLAND, OR 97227(971) 350-0900(971) 350-1490 Get Directions Write a Review

NPPES record last updated: July 20, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Genevieve Pruneau Phd NPPES

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

DR. GENEVIEVE PRUNEAU PHD (NPI 1063751410) is an individual clinical provider in Portland, Oregon, licensed in Oregon (2898) and active in the NPI registry since February 2013. She has opted out of Medicare through June 18, 2027.

NPPES Registry Identity

NPI1063751410
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameDR. GENEVIEVE PRUNEAUCredential: PHD
Location Address3808 N WILLIAMS AVE STE FPortland, OR 97227-1468
Mailing Address3808 N Williams Ave Ste FPortland, OR 97227-1468 · (971) 350-0900 · Fax (971) 350-1490
Phone(971) 350-0900
Fax(971) 350-1490
Sole ProprietorNo
Enumeration DateFebruary 5, 2013
Last NPPES UpdateJuly 20, 2022
NPPES CertifiedJuly 20, 2022
✔ NPI 1063751410 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in OR · 2898
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
3808 N WILLIAMS AVE STE F, Portland, OR 97227
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Genevieve Pruneau Phd 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 June 18, 2025 through June 18, 2027.

Opt-Out Effective DateJune 18, 2025
Opt-Out In Effect ThroughJune 18, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 4

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

KATHERINE KELLEY MARSHALL L.AC.
Acupuncturist
3808 N WILLIAMS AVE STE F
PORTLAND, OR 97227
Multnomah County (503) 754-9443
HILARY K KINAVEY MS, LPC
Counselor (Mental Health)
3808 N WILLIAMS AVE STE F
PORTLAND, OR 97227
Multnomah County (503) 349-9584
MELISSA J KIEFFER
Massage Therapist
3808 N WILLIAMS AVE STE F
PORTLAND, OR 97227
Multnomah County (503) 902-4797
TWIN PINES WELLNESS LLC
Health Maintenance Organization
3808 N WILLIAMS AVE STE F
PORTLAND, OR 97227
Multnomah County (503) 902-4797

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 Genevieve Pruneau's NPI number?

The NPI number for Genevieve Pruneau is 1063751410. It was assigned to this individual provider in the NPPES registry on February 5, 2013.

Where is Genevieve Pruneau located?

Genevieve Pruneau practices at 3808 N Williams Ave Ste F, Portland, OR 97227. The listed phone number is (971) 350-0900.

What is Genevieve Pruneau's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Genevieve Pruneau enrolled in Medicare?

No. Genevieve Pruneau has opted out of Medicare through June 18, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Genevieve Pruneau was last updated on July 20, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.