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MINDFUL THERAPY PACIFIC NW, LLC
NPI 1437810538
Counselor - Mental Health in Portland, OR

Active since January 01, 2022
2245 SW TROY ST, PORTLAND, OR 97219(503) 341-6393(888) 920-2077 Get Directions Write a Review

NPPES record last updated: September 30, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Sep 30, 2024, Dec 12, 2022, Jan 1, 2022 (3 updates tracked since 2022).

About Mindful Therapy Pacific Nw, Llc NPPES

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

MINDFUL THERAPY PACIFIC NW, LLC (NPI 1437810538) is a healthcare organization registered as a mental health in Portland, Oregon and active in the NPI registry since January 2022. The organization lists Jennifer Samsom, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1437810538
Entity TypeOrganization
Primary Taxonomy101YM0800X
Legal Business NameMINDFUL THERAPY PACIFIC NW, LLC
Location Address2245 SW TROY STPortland, OR 97219-2657
Mailing Address2245 Sw Troy StPortland, OR 97219-2657 · (503) 341-6393 · Fax (888) 920-2077
Phone(503) 341-6393
Fax(888) 920-2077
Organization SubpartNo
Authorized OfficialJennifer SamsomExecutive Director · (503) 341-6393
Enumeration DateJanuary 1, 2022
Last NPPES UpdateSeptember 30, 20243 updates tracked since enumeration
NPPES CertifiedSeptember 30, 2024
✔ NPI 1437810538 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
2245 SW TROY ST, Portland, OR 97219
Open in Google Maps ↗

Other Identifiers 2

Medicaid1003129115OR
Medicaid500827243OR

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., Providence Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mindful Therapy Pacific Nw, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Mindful Therapy Pacific NW, LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Jennifer Samsom, MA
Mental Health Counselor
NPI 1003129115
2245 SW TROY ST
Portland, OR 97219
(503) 341-6393
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Mindful Therapy Pacific NW, LLC's NPI number?

The NPI number for Mindful Therapy Pacific NW, LLC is 1437810538. It was assigned to this organization in the NPPES registry on January 1, 2022.

Where is Mindful Therapy Pacific NW, LLC located?

Mindful Therapy Pacific NW, LLC is located at 2245 SW Troy St, Portland, OR 97219. The listed phone number is (503) 341-6393.

What is Mindful Therapy Pacific NW, LLC's specialty?

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

Is Mindful Therapy Pacific NW, LLC enrolled in Medicare?

Yes. Mindful Therapy Pacific NW, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Mindful Therapy Pacific NW, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Mental Health Counselor) reassigns their Medicare billing to Mindful Therapy Pacific NW, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Mindful Therapy Pacific NW, LLC accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., Providence Health Plan and Regence BlueCross BlueShield of Oregon list Mindful Therapy Pacific NW, 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 Mindful Therapy Pacific NW, LLC was last updated on September 30, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.