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IMANI MENTAL HEALTH AND WELLNESS LLC
NPI 1104415405
Nurse Practitioner - Psychiatric/Mental Health in Portland, OR

Active since January 12, 2021
3939 NE HANCOCK ST # 202, PORTLAND, OR 97212(214) 458-1713 Get Directions Write a Review

NPPES record last updated: January 25, 2021. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Jan 25, 2021, Jan 12, 2021 (2 updates tracked since 2021).

About Imani Mental Health And Wellness Llc NPPES

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

IMANI MENTAL HEALTH AND WELLNESS LLC (NPI 1104415405) is a healthcare organization registered as a psychiatric/mental health in Portland, Oregon and active in the NPI registry since January 2021. The organization lists Susan N Mbugua, Mental Health Nurse Practitioner, as its authorized official.

NPPES Registry Identity

NPI1104415405
Entity TypeOrganization
Primary Taxonomy363LP0808X
Legal Business NameIMANI MENTAL HEALTH AND WELLNESS LLC
Location Address3939 NE HANCOCK ST # 202Portland, OR 97212-5321
Mailing Address12063 Sw Taylor CtPortland, OR 97225-5845 · (214) 458-1713
Phone(214) 458-1713
Organization SubpartNo
Authorized OfficialSusan N MbuguaMental Health Nurse Practitioner · (214) 458-1713
Enumeration DateJanuary 12, 2021
Last NPPES UpdateJanuary 25, 20212 updates tracked since enumeration
NPPES CertifiedJanuary 25, 2021
✔ NPI 1104415405 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
3939 NE HANCOCK ST # 202, Portland, OR 97212
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., Regence BlueCross BlueShield of Oregon.Insurance ›

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 Imani Mental Health And Wellness LLC's NPI number?

The NPI number for Imani Mental Health And Wellness LLC is 1104415405. It was assigned to this organization in the NPPES registry on January 12, 2021.

Where is Imani Mental Health And Wellness LLC located?

Imani Mental Health And Wellness LLC is located at 3939 NE Hancock St # 202, Portland, OR 97212. The listed phone number is (214) 458-1713.

What is Imani Mental Health And Wellness LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

What insurance does Imani Mental Health And Wellness LLC accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc. and Regence BlueCross BlueShield of Oregon list Imani Mental Health And Wellness LLC 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 Imani Mental Health And Wellness LLC was last updated on January 25, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.