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CAROLYN WATERFALL LPCI
NPI 1184146565
Counselor - Professional in Portland, OR

Active since July 07, 2017Opted out of Medicare · through Apr 7, 2028
12332 SW 72ND AVE STE 113, PORTLAND, OR 97223(503) 686-3918 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 21, 2022, Jan 26, 2022, Jul 7, 2017 (3 updates tracked since 2017).

About Carolyn Waterfall Lpci NPPES

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

CAROLYN WATERFALL LPCI (NPI 1184146565) is an individual professional provider in Portland, Oregon, licensed in Oregon (R4777) and active in the NPI registry since July 2017. She has opted out of Medicare through April 7, 2028.

NPPES Registry Identity

NPI1184146565
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameCAROLYN WATERFALLCredential: LPCI
Location Address12332 SW 72ND AVE STE 113Portland, OR 97223-8688
Mailing Address12332 Sw 72nd Ave Apt 113Portland, OR 97223-8688 · (503) 686-3918
Phone(503) 686-3918
Sole ProprietorYes
Enumeration DateJuly 7, 2017
Last NPPES UpdateJuly 21, 20223 updates tracked since enumeration
NPPES CertifiedJanuary 26, 2022
✔ NPI 1184146565 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in OR · R4777
12332 SW 72ND AVE STE 113, Portland, OR 97223
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

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Opted out of Medicare

Carolyn Waterfall Lpci 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 April 7, 2024 through April 7, 2028.

Opt-Out Effective DateApril 7, 2024
Opt-Out In Effect ThroughApril 7, 2028Opt-out affidavits renew automatically every two years unless cancelled

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 Carolyn Waterfall's NPI number?

The NPI number for Carolyn Waterfall is 1184146565. It was assigned to this individual provider in the NPPES registry on July 7, 2017.

Where is Carolyn Waterfall located?

Carolyn Waterfall practices at 12332 SW 72nd Ave Ste 113, Portland, OR 97223. The listed phone number is (503) 686-3918.

What is Carolyn Waterfall's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Carolyn Waterfall enrolled in Medicare?

No. Carolyn Waterfall has opted out of Medicare through April 7, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

What insurance does Carolyn Waterfall accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans and Regence BlueCross BlueShield of Oregon list Carolyn Waterfall 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 Carolyn Waterfall was last updated on July 21, 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.